title: Hybrid angioplasty for left pulmonary artery stenosis after total correction of tetralogy of Fallot: report of one case.
abstract: Pulmonary artery stenosis is common in tetralogy of Fallot. Surgical correction usually achieves good results. For those patients undergoing total correction with residual pulmonary artery stenosis, percutaneous transluminal angioplasty (PTA) plays an important role. However, this might not be possible for complex anatomies. We report a 19-month-old boy who underwent total correction of tetralogy of Fallot at 1 year of age. He developed main pulmonary artery (MPA) aneurysm and left pulmonary artery (LPA) stenosis 4 months after the operation. PTA was attempted, but the guidewire failed to thread into the LPA due to the dilated MPA and tiny LPA ostium. A hybrid approach consisting of left anterior small thoracotomy and balloon angioplasty via the introducer sheath in the MPA was proposed. Rapid access to the LPA and successful balloon angioplasty followed by stenting concluded the hybrid intervention. Such intervention is a good alternative to treat this complex anatomy.
authors.affiliation: Department of Cardiovascular Surgery, Far-Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: Kuan-Ming
authors.initials: KM
authors.lastname: Chiu
authors.forename: Jer-Shen
authors.initials: JS
authors.lastname: Chen
authors.forename: Shu-Jen
authors.initials: SJ
authors.lastname: Yeh
authors.forename: Tzu-Yu
authors.initials: TY
authors.lastname: Lin
authors.forename: Juine-Yih
authors.initials: JY
authors.lastname: Ma
authors.forename: Shao-Jung
authors.initials: SJ
authors.lastname: Li
authors.forename: Shu-Hsun
authors.initials: SH
authors.lastname: Chu
mesh_terms: D000800:Angioplasty, Balloon / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D011651:Pulmonary Artery; D013771:Tetralogy of Fallot / Q000601:surgery*