open access

Vol 15, No 4 (2008)
Case Reports
Published online: 2008-05-21
Submitted: 2013-01-14
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Right ventricle outflow tract stenting as a method of palliative treatment of severe tetralogy of Fallot

Paweł Dryżek, Anna Mazurek-Kula, Tomasz Moszura, Andrzej Sysa
Cardiol J 2008;15(4):376-379.

open access

Vol 15, No 4 (2008)
Case Reports
Published online: 2008-05-21
Submitted: 2013-01-14

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.

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.
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Keywords

tetralogy of Fallot; stent; treatment

About this article
Title

Right ventricle outflow tract stenting as a method of palliative treatment of severe tetralogy of Fallot

Journal

Cardiology Journal

Issue

Vol 15, No 4 (2008)

Pages

376-379

Published online

2008-05-21

Bibliographic record

Cardiol J 2008;15(4):376-379.

Keywords

tetralogy of Fallot
stent
treatment

Authors

Paweł Dryżek
Anna Mazurek-Kula
Tomasz Moszura
Andrzej Sysa

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