Staged Percutaneous Management of Pulmonary Atresia and Intact Interventricular Septum: Stretching the Limits

Figure 3

Case 3 (nightmare case). (a) MSCT showing a tubular-shaped MPA and distance to bifurcation. (b) Stent and Melody valves were displaced downward in RVOT. (c) Attempting to push the valve and stent back upward using a balloon. (d) Placing a second stent within the stent/valve system and sacrificing the first valve. (e) End result with the second Melody 22 mm PV placed higher in the MPA and well functioning.

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(b)

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(e)