Transcatheter balloon valvuloplasty had been established as the treatment of choice in patients with pulmonary valvar stenosis. Non surgical closure of secundum atrial defects by various occlusive devices is currently being evaluated. We report the first successful simultaneous transvenous Mansfield balloon dilation and Amplatzer septal occlusion in a 7-year-old girl with moderately severe pulmonary valvar stenosis and secundum atrial defect in April 1997. Satisfactory reduction of pressure gradient across pulmonary valve and complete obliteration of left to right atrial shunt were achieved.
Congenital pulmonary valvar stenosis (PVS) and secundum atrial septal defect (ASD) are relatively common forms of congenital heart disease (CHD). Since the first successful clinical application of transcatheter balloon dilation of PVS in 1982, the latter has become the treatment of choice for children with PVS who have significant transpulmonary valvar peak to peak systolic pressure gradient greater than 50 mm Hg.
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