19 year old male ,Known case TOF s/p total repair since 2007Clinical FC I, no DOE- V/S: BT 36.7°C, PR 66/min, BP 109/77 mmHg, RR 18/min, O2sat 100%
- Heart: no heave, no thrill, normal S1, S2, to and fro at LUPSBCXR : Mild Cardiomegaly  ECG; NSR, rate 60 bpm, -15 degree, QRSd 142 msec, CRBBB Echo : Severe PR  ,PV annulus20.7 mm ,No branch PS ,Good biventicular functionMRI : PRF 46% RVEDVi 184.6 ml/m2  RVESVi 94 ml/m2RVEDv/LVEDv 2.48RVEF 48.2 %LVEF 48.4%

PA gram : Waist 34 mm in RAO view , Waist 40 mm in LAO view , Waist 36 mm in LAT view , RVOT aneurysm 48 mmThe right femoral vein is patent with a diameter of 13.5 mmNo coronary compression during balloon interrogationsummary rTOF with free PRType IV RVOT (fusiform) with waist diameter 35x35 mm
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1. Preclosed Proglide was done before procedure2. MPAangiogram in RAO cranial and true lateral view show pyramidal shape RVOT withwaist dimeter 36x36 mm , bifurcation 29.5 x 29.5 mm , length 28.5 x 29.4 mm3. With 34mm balloon sizing , waist dimeter 29 x 31 mm , No coronary compression duringballoon interrogation4. 26 Frlong Gore DrySEAL was inseted to PA branch , Venus P valve 36/25  was selected to implant at RVOT5. After procedure , RV gram and PA angiogram show good device position , No PR , Nosignificant PA-RV gradient , No obstruction at both PA branch6. CAG show no coronary obstructionComplication : none
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Percutaneous pulmonic valve implantation using the newself-expandable Venus P-valve proved to be a safe and viable procedure,enabling the treatment of highly dilated right ventricular outflow tracts  with aneurysmal change that are unsuitable forexisting balloon-expandable valves.