Novel materials and devices in the transcatheter management of congenital heart diseases-the future comes slowly (part 3).

Correction of malformations affecting the right ventricular outflow tract often results in residual abnormalities that require valve implantation at a later stage to prevent right ventricular deterioration. In the paediatric population, the pathology of congenital valve stenosis or insufficiency is often complex, options for surgical repair are limited, and valve replacement remains the only-albeit unattractive-alternative. Prosthetic heart valve implantation can be performed either surgically or, nowadays, percutaneously. Current transcatheter devices allow less invasive percutaneous valve implantation in selected patients after surgical repair, but are suitable for only a small portion of paediatric patients. In addition, there is a large heterogeneous group of patients who undergo surgical constriction of the pulmonary trunk, either to reduce pulmonary blood flow or to retrain or support the left ventricle. In the third part of this review series, we focus on new biomaterials, devices and technologies that have the potential to extend transcatheter valve implantation to a broader spectrum of congenital cardiovascular lesions, with safe and durable results in children, and on transcatheter options for the creation of a partial obstruction within the pulmonary trunk (pulmonary artery banding).