Figure 3.

Valve implantation in the presence of left pulmonary artery stenosis. Severe conduit stenosis (white arrow) and left pulmonary artery stenosis (black arrow) seen in left anterior oblique projection (a) were stented (b) before a straight Venus P-valve implantation (c). The left pulmonary artery stent did not hinder the valve delivery system. Extreme hypoplasia of left pulmonary artery in the second patient with native outflow tract (d) forced a right pulmonary artery (RPA) deployment (e) of a flared Venus P-valve. (f) A sharp kink in left pulmonary artery (LPA) origin shown in left anterior oblique projection (g) in third patient was crossed by the delivery system of a flared Venus P-valve aided by a balloon in the outflow tract (h). A similar angulation in fourth patient would not permit the delivery system (i) and managed by a RPA deployment