Dear, first of all, please understand that pulmonary stenosis is basically the tightness of one of the valves on the right side of the heart and in your daughter s case, it seems to be by birth. You have mentioned that she underwent cardiac cath at the age of 1, but you didnot mention that only the cath study was done and what was the gradient at that time or the ballooning was also done. Now she is 7 years old and she never had any symptoms as per you (I presume she never had palpitations, loss of consciousness, chest pain, swelling feet or face, easy fatigability), so I would just do ECHO to look for the gradient across the pulmonary valve and then decide if the cardiac cath is required or not. Now coming to your worry about the leakage in the valve. A tight valve is rigid and it doesn t close properly sometimes leading to leakage which can sometimes become worrisome and needs surgery. And ballooning of the tight valve can also lead to some leakage in the valve and this ballooning is done only if there is no leakage initially. I hope I have cleared your queries to some extent!! All the best