TRANSCATHETER MANAGEMENT OF NEONATES WITH PULMONARY ATRESIA AND INTACT VENTRICULAR SEPTUM

This report describes a 1-day-old infant with valvar pulmonary atresia with intact ventricular septum in whom we were successful in performi ng transcatheter guidewire perforation and balloon pulmonary valvulopl asty to establish right ventricle-to-pulmonary artery continuity and f low, Also described is implantation of a 4 mm coronary stent into duct us arteriosus in lieu of surgical aortopulmonary shunt to treat pulmon ary oligemia and systemic arterial hypoxemia. Details of transcatheter guidewire perforation are presented and it is suggested that this met hod be used as an alternative to Laser/radio frequency wires, especial ly in the absence of approval of the latter wires by the regulatory ag encies, Stenting of the ductus may be considered an alternative to sur gical aortopulmonary shunt, Role of transcatheter technology in the ma nagement of selected patients with pulmonary atresia and intact ventri cular septum is discussed. (C) 1997 Wiley-Liss, Inc.