Therapy for valvular heart disease in children has undergone tremendou
s progress over the past two decades. Interventional catheterization t
echniques were pioneered with balloon valvuloplasty of pulmonic stenos
is in infants. Therapeutic catheterization is the treatment of choice
in critical pulmonic stenosis but remains somewhat controversial for n
eonatal aortic stenosis. The use of cryopreserved homografts has impro
ved reconstruction of the right ventricular outflow tract. The pulmona
ry autograft (Ross) technique for aortic Valve replacement has now bee
n applied in neonates, infants, and small children. Medium-term result
s of this technique are now becoming available. Innovations have been
few, however, in the therapy of tricuspid valve anomalies, especially
Ebstein's malformation. Annuloplasty and repair techniques are used ve
ry effectively for mitral insufficiency, whereas congenital mitral ste
nosis remains extremely problematic in the younger child. (C) 1997 Rap
id Science Publishers.