Stenting of a stenosed major aortopulmonary collateral artery in a baby with pulmonary atresia and a ventricular septal defect: rescue from critical hypoxia in the immediate postoperative stage of unifocalization supported by extracorporeal membrane oxygenation.
A 4-month baby with pulmonary atresia, ventricular septal defect, major aortopulmonary collateral arteries (MAPCAs) and an extremely hypoplastic central pulmonary artery developed critical hypoxia following right unifocalization combined with a right Blalock-Taussig shunt. To increase pulmonary blood flow we stented the left lower MAPCA during extracorporeal membrane oxygenation (ECMO) support. He was successfully weaned from ECMO 2 days after stenting. Percutaneous intervention for a stenosed MAPCA is an effective means of increasing pulmonary blood flow in critically hypoxic patients following unilateral unifocalization, even in the immediate postoperative stage.
Tomita
Hideshi
H
Cardiovascular Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan. tomitah@med.showa.a.ac.jp
Matsuoka
Takashi
T
Uemura
Shigeru
S
D000800:Angioplasty, Balloon / Q000295:instrumentation*; D001011:Aorta / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003097:Collateral Circulation; D003251:Constriction, Pathologic; D005112:Extracorporeal Circulation; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D000860:Hypoxia / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D007223:Infant; D008297:Male; D011182:Postoperative Care; D011651:Pulmonary Artery / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery*; D018633:Pulmonary Atresia / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D011652:Pulmonary Circulation; D012039:Regional Blood Flow; D015607:Stents; D016896:Treatment Outcome