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Isolated congenital tricuspid valve stenosis is a rare entity. The modalities of definitive treatment have been surgical repair or replacement. We present the first reported patient with congenital tricuspid stenosis successfully treated by percutaneous balloon valvotomy. This appears to be an alternative to surgery when the anatomy, as demonstrated by echocardiography, is suitable.

Balloon valvuloplasty has already gained its place as an alternative option in the treatment of valvar stenoses. In congenital valvar stenosis its application will be limited because of the complexity of the underlying valve deformities. Nevertheless, isolated pulmonary and aortic valve stenosis are amenable to this form of treatment. The major limitations are undeveloped arterial valve rings and valve dysplasia. In acquired valvar stenosis the main limitation of balloon valvuloplasty seems to be massive calcification of the affected valves. Basically, in both the arterial and atrioventricular position, balloon valvuloplasty splits fused commissures and fractures calcific deposits. Excessive radial pressures may cause tears of the leaflets. The potential of thromboembolic complications, therefore, warrants caution. The nature of the damage inflicted on pathologic valves almost by necessity dictates that restenosis will occur and - most likely - with a high incidence.

Percutaneous balloon valvuloplasty was successfully performed in a 55-year-old Chinese woman with severe recurrent tricuspid and pulmonic stenoses 11 1/2 years following open valvotomies. An Inoue balloon catheter with the balloon made of double-layered rubber and nylon micromesh was used. The orifices of the tricuspid and pulmonic valves increased from 13 to 27 mm in diameter and from 6 to 14 mm in diameter, respectively, following concurrent balloon valvuloplasties. The present report demonstrated for the first time the feasibility of percutaneous balloon valvuloplasty for combined valvular stenoses.