title: A novel balloon assisted two-stents telescoping technique for repositioning an embolized stent in the pulmonary conduit.
abstract: A 9-year-old male, with history of pulmonary atresia and ventricular septal defect, status post complete repair with a 16 mm pulmonary homograft in the right ventricular outflow tract (RVOT) underwent 3110 Palmaz stent placement for conduit stenosis. Following deployment the stent embolized proximally into the right ventricle (RV). We undertook the choice of repositioning the embolized stent into the conduit with a transcatheter approach. Using a second venous access, the embolized stent was carefully maneuvered into the proximal part of conduit with an inflated Tyshak balloon catheter. A second Palmaz 4010 stent was deployed in the distal conduit telescoping through the embolized stent. The Tyshak balloon catheter was kept inflated in the RV to stabilize the embolized stent in the proximal conduit until it was successfully latched up against the conduit with the deployment of the overlapping second stent. One year later, he underwent Melody valve implantation in the pre-stented conduit relieving conduit insufficiency. This novel balloon assisted two-stents telescoping technique is a feasible transcatheter option to secure an embolized stent from the RV to the RVOT.
authors.affiliation: Division of Pediatric Cardiology, Children's Hospital of Michigan, Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kobayashi
authors.forename: Srinath T
authors.initials: ST
authors.lastname: Gowda
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Forbes
mesh_terms: D064591:Allografts; D000800:Angioplasty, Balloon / Q000009:adverse effects* / Q000295:instrumentation*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D002648:Child; D003251:Constriction, Pathologic; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006343:Heart Septal Defects / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D018633:Pulmonary Atresia / Q000175:diagnosis / Q000601:surgery*; D015641:Radiography, Interventional; D015607:Stents; D016896:Treatment Outcome
keywords: balloon assist; pediatric intervention; stent embolization; two-stents telescoping