[Percutaneous transluminal angioplasty in stenosis of Blalock-Taussig pulmonary systemic shunt in an adult patient].
OBJECTIVE
The report of a female patient with tricuspid atresia and severe stenosis of the pulmonary artery, stenosis of the left pulmonary-systemic shunt and occlusion of the right systemic-pulmonary shunt.


BACKGROUND
The use of transluminal angioplasty has been extended to the treatment of several congenital cardiopathies and, in some of them, it is the therapeutic procedure of choice.


METHODS
Dilatation of the distal stenosis of the pulmonary-systemic shunt with a coaxial system composed initially by an 8 French right Judkins carrier catheter with a soft tip through which a 0.014" (0.036 cm) coronary angioplasty guidewire and 3 and 4 mm balloon catheters were advanced successively. Subsequently a 0.028" interchange Rosen guide was advanced, gradually introducing balloon catheters up to 8 mm of diameter.


RESULTS
The dilatation with balloon catheter systems of increasing diameter allowed to amplify the stenosis zone, improving arterial oxygen partial pressure and saturation without evidences of left lung hyperflux. Considering the anatomic characteristics of the pulmonary systemic shunt, the use of carrier catheters facilitates the penetration of balloon catheters to the stenosis zone.


CONCLUSIONS
Percutaneous transluminal angioplasty may be used with success in patients with stenosis of Blalock-Taussig shunts, independent of the anastomosis curvature and even if the magnitude of the stenosis is significant.
Ramírez
A
A
Centro Cardiovascular Hospital Clínico, Universidad de Chile, Santiago de Chile.
Hernández
I
I
Arcile
G
G
Farrú
O
O
Silva
A M
AM
Quispe
P
P
D000328:Adult; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000628:therapy; D011651:Pulmonary Artery / Q000601:surgery; D011666:Pulmonary Valve Stenosis / Q000150:complications / Q000628:therapy*; D013348:Subclavian Artery / Q000601:surgery; D014261:Tricuspid Valve / Q000002:abnormalities*
Angioplastía percutánea transluminal en estenosis de la derivación sistémico pulmonar de Blalock-Taussig en paciente adulto.