Percutaneous pulmonary valvuloplasty and atrial septal defect closure in a 69-year-old patient with Noonan's syndrome.

We present the case of a patient with Noonan syndrome who was seen for the first time at the age of 69 years with combined pulmonary valve stenosis and atrial septal defect. The patient was treated by a staged percutaneous approach. The treatment of these combined congenital heart defects remains challenging because their haemodynamics interact directly. In this case report we discuss both the underlying pathophysiology and haemodynamics.