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Figure 3: PA-IVS with moderate RV hypoplasia. Ductal stenting by retrograde femoral artery route after radiofrequency and valvotomy balloon dilatation. (A) Lateral projection shows - almost like Krichenko type A ductus but more elongated, with a very tight constriction at the pulmonary end. The tip of 4-F long sheath is positioned near the ampulla. 0.014 guidewire is passed through catheter across the ductus using a JR catheter to the RV, RA and IVC. (B) Angiogram in LAO 30 cranial 25 projection demonstrating the insertion of ductus onto the roof of MPA away from the LPA origin. (C) Balloon-stent ensemble positioned along the length of ductus ready for expansion. (D) Post-expansion angiogram. Entire length of ductus is covered by stent with no encroachment of origin of branch pulmonary artery. Ductal stenting by transvenous route in another patient with PA-IVS after RF valvotomy. (E) JR guiding catheter is used for stent delivery (small arrow). Expanded stent (big arrow) is seen well clear of LPA and RPA origins

Figure 3: PA-IVS with moderate RV hypoplasia. Ductal stenting by retrograde femoral artery route after radiofrequency and valvotomy balloon dilatation. (A) Lateral projection shows - almost like Krichenko type A ductus but more elongated, with a very tight constriction at the pulmonary end. The tip of 4-F long sheath is positioned near the ampulla. 0.014 guidewire is passed through catheter across the ductus using a JR catheter to the RV, RA and IVC. (B) Angiogram in LAO 30 cranial 25 projection demonstrating the insertion of ductus onto the roof of MPA away from the LPA origin. (C) Balloon-stent ensemble positioned along the length of ductus ready for expansion. (D) Post-expansion angiogram. Entire length of ductus is covered by stent with no encroachment of origin of branch pulmonary artery. Ductal stenting by transvenous route in another patient with PA-IVS after RF valvotomy. (E) JR guiding catheter is used for stent delivery (small arrow). Expanded stent (big arrow) is seen well clear of LPA and RPA origins