title: Transcatheter left ventricular outflow tract stent placement in a low birth weight child with hypoplastic left ventricle, mitral atresia, transposition of the great arteries, ventricular septal defect and severe pulmonary stenosis.
abstract: A baby boy, the first of triplets born at 33 weeks gestation weighing 1.88 kg, presented with neonatal cyanosis and was diagnosed with mitral atresia, hypoplastic left ventricle, ventricular septal defect, d-transposition of the great arteries, severe pulmonary stenosis, and hypoplastic branch pulmonary arteries. He was treated with prostaglandin until seven weeks of age. The patent ductus arteriosus was curly Q and not suitable for stent placement. Cardiac catheterization was undertaken and using an antegrade approach, a Multi-Link Ultra stent was implanted across the left ventricular outflow tract (LVOT) and inflated to 5 mm to improve antegrade pulmonary blood flow. This allowed reasonable pulmonary arterial growth to allow the patient undergo bidirectional Glenn shunt at five months of age. This first report of LVOT stenting in this setting may provide an alternative to placement of a systemic to pulmonary arterial shunt when ductal stenting is not possible.
authors.affiliation: Department of Paediatric Cardiology, Crumlin, Dublin 12, Ireland.
authors.forename: Colin J
authors.initials: CJ
authors.lastname: McMahon
authors.forename: Conall T
authors.initials: CT
authors.lastname: Morgan
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Walsh
mesh_terms: D000015:Abnormalities, Multiple; D006328:Cardiac Catheterization / Q000295:instrumentation*; D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000175:diagnosis; D018729:Fontan Procedure; D005865:Gestational Age; D006345:Heart Septal Defects, Ventricular / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000150:complications* / Q000175:diagnosis; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D008943:Mitral Valve / Q000002:abnormalities*; D010166:Palliative Care; D011453:Prostaglandins / Q000627:therapeutic use; D011666:Pulmonary Valve Stenosis / Q000150:complications* / Q000175:diagnosis; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000150:complications* / Q000175:diagnosis; D016896:Treatment Outcome; D014310:Triplets; D014694:Ventricular Outflow Obstruction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
chemical_list: D011453:Prostaglandins
keywords: hypoplastic left ventricle; pulmonary stenosis; stent; transposition