Vol 15, No 4 (2008)
Case Reports
Published online: 2008-05-21
Right ventricle outflow tract stenting as a method of palliative treatment of severe tetralogy of Fallot
Cardiol J 2008;15(4):376-379.
Abstract
We present the case of a 3-month-old infant with tetralogy of Fallot (ToF) with pulmonary
artery hypoplasia, critical right ventricle outflow tract (RVOT) obstruction and the presence of
major aortopulmonary collateral arteries (MAPCA) and CATCH 22 syndrome. Due to anatomical
conditions (severe pulmonary artery hypoplasia), the patient was not qualified for
palliative operative treatment Blalock-Taussig shunt. We conducted catheterization with an
attempt of balloon plasty and stent implantation into the right ventricle outflow tract and main
pulmonary artery. Successful stent implantation into the right ventricle outflow tract was
performed. The stent created a 4.1 mm diameter channel and allowed for unrestricted blood
flow from the right ventricle to the pulmonary arteries. After the procedure we observed an
increase in blood saturation of up to 89%.
Control echocardiography revealed blood flow through the stent to the pulmonary arteries with a pressure gradient of 45 mm Hg. There were neither rhythm nor conduction disturbances in the control ECG after the procedure.
After 6 days of observation the patient was discharged from our department.
We conclude that successful stent implantation into the RVOT in patients with ToF and hypoplastic pulmonary arteries improves their clinical condition, increases pulmonary blood flow by physiological means and leads to an improvement of pulmonary artery development before surgical treatment.
Control echocardiography revealed blood flow through the stent to the pulmonary arteries with a pressure gradient of 45 mm Hg. There were neither rhythm nor conduction disturbances in the control ECG after the procedure.
After 6 days of observation the patient was discharged from our department.
We conclude that successful stent implantation into the RVOT in patients with ToF and hypoplastic pulmonary arteries improves their clinical condition, increases pulmonary blood flow by physiological means and leads to an improvement of pulmonary artery development before surgical treatment.
Keywords: tetralogy of Fallotstenttreatment