Transcatheter pulmonary valve implantation: An option for the few becoming an option for the many

A wide variety of congenital heart defects, from valvar pulmonary stenosis and tetralogy of Fallot to pulmonary atresia and double outlet right ventricle, require intervention on the right ventricular outflow tract (RVOT), including replacement of the pulmonary valve or intervention on a failing a right ventricular (RV)-to-pulmonary artery (PA) conduit. Haemodynamic lesions involving the RVOT are typically associated with pressure and/or volume overload of the RV, and can cause exercise intolerance, arrhythmia, syncope, and heart failure.