For pulmonic stenosis, percutaneous balloon valvuloplasty remains first-line and highly effective, substantially reducing the transvalvular gradient and improving valve orifice area with durable results and few complications in adolescents and adults. For pulmonic regurgitation — most often a long-term consequence of repaired congenital disease — transcatheter pulmonary valve replacement (TPVR) has become a valuable non-surgical option, improving right ventricular function and reducing the need for reintervention. Historically performed with the balloon-expandable Melody and SAPIEN valves in conduits, TPVR has been extended to the large native or patched outflow tract by the self-expanding devices approved in 2021 (Harmony and Alterra), broadening the pool of eligible patients.
Further reading: balloon valvuloplasty for pulmonic stenosis (Chen et al.); transcatheter pulmonary valve replacement reviews (Morray & McElhinney); Harmony and Alterra self-expanding TPVR data.