From atretic to perforated: a closer view of pulmonary atresia.

A 7-day-old male infant with membranous pulmonary atresia and intact ventricular septum (PA/IVS) underwent hybrid pulmonary valvotomy. Access was via median sternotomy guided by intra-operative epicardial ultrasonography. After puncturing the atretic pulmonary valve, a 6 mm Wanda balloon catheter was inflated to dilate the atretic valve.