Role of Echocardiography in Catheter Interventions for the Right Ventricular Outflow Tract

The treatment strategies and timing of corrective or palliative procedures for patients with right ventricular outflow tract (RVOT) obstruction vary depending on the lesion and also on the severity of the patient's symptoms. A wide variety of right heart obstructive lesions ranging from severe valvar pulmonary stenosis, pulmonary atresia with intact ventricular septum, and tetralogy of Fallot can be treated effectively with corrective or palliative interventions in the catheterization laboratory. Interventional procedures to relieve right ventricular outflow obstruction and/or to augment antegrade pulmonary blood flow include balloon pulmonary valvotomy, pulmonary valve perforation, and RVOT stenting. In all these interventions, echocardiography plays an essential role, not only in the preprocedural assessment and case selection but also during the actual procedure in the catheter laboratory. With proper use, a transthoracic echocardiogram can minimize radiation exposure, help in stent positioning in the RVOT, and even detect complications instantaneously. This manuscript reviews the role of echocardiography in transcatheter interventions of the RVOT.