This week we review a recent report of 4 patients with serious complications related to either perforation or external compression from the distal tines of the Alterra prestent when used for transcatheter pulmonary valve replacement. We speak with Dr. R. Allen Ligon, interventional cardiologist at Children's Healthcare of Atlanta/Emory University about a recent multicenter report of rare complications seen with this prosthesis. How common are perforations seen with this device and how often are these clinically silent? What should be done for clinically silent prestent perforations? What sort of surveillance of all patients with this device is warranted after successful placement? These are amongst the questions posed to Dr. Ligon and discussed this week. 

DOI: 10.1016/j.jaccas.2024.102836