title: Stenting an aortopulmonary conduit with peripheral cardiopulmonary bypass support.
abstract: Although surgically created aortopulmonary (AP) shunts are uncommon in the adult congenital heart disease population, they are often used in patients with pulmonary atresia. For these patients, the shunt is a vital supply of pulmonary blood flow and thus obstruction of the shunt may lead to pulmonary hypoperfusion and hypoxia thereby increasing morbidity and mortality. This report describes a safe and effective method of stenting the conduit with the hemodynamic support of peripheral cardiopulmonary bypass (PCB). Prior to the procedure, a multimodality assessment of a stenosis in a kinked AP conduit using computed tomography, angiography, intravascular ultrasound (IVUS), and pressure wire assessment (PWA) was utilized. While PCB, IVUS, and PWA have all been used to great effect in various clinical scenarios, the combined use of these techniques has not been previously been described in the setting of intervention in adult congenital heart disease.
authors.affiliation: Cardiology Program, The Prince Charles Hospital, Rode Rd, Chermside, Queensland, 4032, Australia; School of Medicine, University of Queensland, Herston Rd, Herston, Queensland, 4006, Australia.
authors.forename: Alexander
authors.initials: A
authors.lastname: Incani
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Lee
authors.forename: Mugur J
authors.initials: MJ
authors.lastname: Nicolae
authors.forename: Darren L
authors.initials: DL
authors.lastname: Walters
mesh_terms: D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D006328:Cardiac Catheterization / Q000295:instrumentation*; D002315:Cardiopulmonary Bypass; D003097:Collateral Circulation; D003251:Constriction, Pathologic; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D008875:Middle Aged; D011652:Pulmonary Circulation; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014654:Vascular Patency
keywords: congenital heart disease in adults; intravascular ultrasound; percutaneous coronary intervention