54. Radiofrequency perforation of pulmonary valve and PDA stenting in a preterm neonate

Transcatheter radiofrequency perforation of the pulmonary valve and PDA stenting is considered as a modality for pulmonary atresia and intact ventricular septum with mildly hypoplastic tripartate right ventricle. We present a preterm neonate who has undergone this procedure. we assume that transcatheter radiofrequency perforation of pulmonary valve and PDA stenting is a safer approach for pulmonary atresia with intact ventricular septum in preterm newborns, than surgical approach.We present 5 days old, preterm (36 weeks gestation) baby girl, with 2.2kg. She was reffered to our centre with the diagnosis of pulmonary atresia with intact ventricular septum, mildly hypoplastic tripartate right ventricle. Right ventricle angiography showed tripartate right ventricle with no sinusoids. She underwent successful radiofrequency perforation of pulmonary valve followed by balloon dilatation. At the same time prograde PDA stenting was done. Repeat right ventricle angiography showed good right ventricular outflow tract forward flow, and descending aorta angiography showed good PDA flow supplying both pulmonary arteries. The baby was extubated on same day, and prosoglandin E1 was discontinued immediately after the procedure.The baby mainatined saturation more than 80% on room air. The baby was discharged after 2 days. Our case is pecular because to our knowledge this is the lowest weight for wich radiofrequency perforation and PDA stenting is done as well as being preterm