The use of a wire control catheter to treat complex pulmonary artery or vein anatomy.
The difficult performance of certain percutaneous interventions in the field of congenital heart disease is well known. Crossing pulmonary arteries in patients who have previously undergone surgical repair or stenotic pulmonary veins in infants can be typical examples of these technical challenges in the catheterization laboratory. The Venture wire 6 Fr control catheter (St Jude Medical) is compatible with a steerable tapered radiopaque tip that can be manually angulated (up to 90°) by clockwise rotation of a knob located in the proximal handle. This mechanism directs any 0.014″ guidewire and provides back-up support. This catheter has been successfully used in coronary artery intervention for crossing severely tortuous vessels, extreme angulations of side-branch ostia, jailed stents, saphenous vein graft anastomoses, and chronic total occlusions. We report the first use of the Venture wire control catheter (St Jude Medical) in the field of congenital heart disease. Patient #1 was diagnosed with pulmonary atresia and ventricular septal defect and had a proximally migrated stent in the pulmonary trunk and severe left pulmonary artery stenosis. We have used this catheter in order to cross this stent and perform left pulmonary artery stent placement. Patient #2 had postoperative vein restenosis after surgery. The Venture catheter was used to reach the obstructed insertion of the right medium lobe pulmonary vein from a transseptal approach. Techniques from coronary interventional colleagues can help interventional cardiologists in the field of congenital heart disease to treat complex situations.
Instituto de Cardiologia do Rio Grande do sul/Fundacao Univeritåria de Cardiologia (IC/FUC) Cardiologia Invasiva, Porto Alegre, Brazil.
Joao Luiz L
JL
Manica
Luciane
L
Piazza
Gianfranco
G
Butera
D062906:Cardiac Catheters; D002648:Child; D006330:Heart Defects, Congenital / Q000473:pathology / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation* / Q000379:methods; D011651:Pulmonary Artery / Q000473:pathology; D018633:Pulmonary Atresia / Q000473:pathology / Q000628:therapy*; D011666:Pulmonary Valve Stenosis / Q000473:pathology / Q000628:therapy*; D011667:Pulmonary Veins / Q000473:pathology; D016896:Treatment Outcome