title: Stenting of central aortopulmonary shunt in a child with pulmonary atresia, ventricular septal defect, and severely hypoplastic pulmonary arteries.
abstract: A male infant was born at 28 weeks gestation weighing 850 g. He was diagnosed with pulmonary atresia, ventricular septal defect and major aorto-pulmonary collaterals with severely hypoplastic true pulmonary arteries. A 3.5 mm Gore-Tex central shunt was anastomosed from the ascending aorta to the main pulmonary artery at 4 months of age and a weight of 3.5 kg. The left pulmonary artery measured 1-2 mm and the right pulmonary artery measured 1 mm. His saturations increased from 70% to 85% following placement of the central shunt. At 16 months of age, his oxygen saturation decreased to 68%. Cardiac catheterization, using a retrograde approach, and angiography demonstrated a moderate degree of stenosis within the distal shunt and a severe left pulmonary arterial stenosis. A 4 x 18 mm Multi-Link Vision coronary stent was implanted within the stenotic central shunt and angioplasty of the left pulmonary arterial stenosis was performed. The oxygen saturation improved to 84% after the procedure. Although stenting of the Blalock-Taussig shunt has been described previously, this represents one of the first reports of stenting of a central aortopulmonary shunt. This significantly improved the patient's oxygen saturation and allowed the potential for some further central pulmonary arterial growth prior to unifocalization procedure.
authors.affiliation: Cardiac Department, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland. cmcmahon992004@yahoo.com.
authors.forename: Colin J
authors.initials: CJ
authors.lastname: McMahon
authors.forename: Orla
authors.initials: O
authors.lastname: Franklin
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Walsh
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000792:Angiography; D001011:Aorta / Q000503:physiopathology / Q000601:surgery*; D003097:Collateral Circulation / Q000502:physiology; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D006343:Heart Septal Defects / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011651:Pulmonary Artery / Q000503:physiopathology / Q000601:surgery*; D018633:Pulmonary Atresia / Q000503:physiopathology / Q000601:surgery*; D011652:Pulmonary Circulation / Q000502:physiology; D015607:Stents; D016896:Treatment Outcome