**6. Challenges**

The procedure is a technically difficult procedure with a significant learning curve and is difficult to execute in a new program.

Requirement of re-interventions, especially if performed in early neonatal period with very hypoplastic pulmonary arteries.

Difficult corrective surgery post stenting- Removal of stent can be challenging with increased cardiopulmonary bypass time, sometimes the posterior aspect of stent is left in situ, and concerns of injury to adjoining structures like aortic and tricuspid valve can complicate the post-op recovery.

Long term data on RVOT stenting is lacking, especially RV dilatation, growth of pulmonary vessels and need for re-interventions.
