Key result
Buddy balloon technique facilitates optimal Harmony valve positioning in a complex dilated RVOT.
Why the study?
Complex and dilated right ventricular outflow tracts make deployment of self-expanding pulmonary valves difficult, with a higher probability of malalignment.
Case Report (n=1)
A 'buddy balloon' technique can be used to reorient and optimally position a self-expanding Harmony valve in patients with complex and dilated RVOTs.
OBJECTIVE: To describe the use of a balloon-assisted technique for placement of a Harmony valve in a patient with tetralogy of Fallot and a dilated right ventricular outflow tract (RVOT). KEY STEPS: Harmony valve malalignment can happen with pyramidal-type outflow tracts. Using a large compliant balloon, we inflated the balloon across the misaligned segment of the partially deployed Harmony valve. Once correctly aligned in the RVOT, we proceeded with standard deployment. POTENTIAL PITFALLS: Retrieval of the valve back into the delivery catheter can be difficult to impossible and may require use of a Gore 26-F DrySeal sheath to retrieve. TAKE-HOME MESSAGES: Complex and dilated RVOTs make deployment of self-expanding valves difficult, with a higher probability of malalignment. We describe a simple "buddy balloon" technique for reorienting the distal valve apparatus to reposition the valve optimally in the RVOT before release.
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Herron et al. (2025) conducted a case report in Tetralogy of Fallot and a dilated right ventricular outflow tract (n=1). Simultaneous balloon technique ('buddy balloon') was evaluated on Optimal repositioning and deployment of the valve in the RVOT. A simultaneous 'buddy balloon' technique successfully reoriented a partially deployed Harmony valve for optimal positioning in a patient with a complex and dilated right ventricular outflow tract.
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