Iatrogenic aortopulmonary window after balloon dilation of left pulmonary artery stenosis following arterial switch operation.
ABSTRACT Branch pulmonary artery stenosis may occur in 4%-28% of patients after an arterial switch operation. Balloon dilation can be attempted with variable results, while stenting is a more definitive option when balloon dilation fails. We report the case of a young boy who underwent balloon dilation of a stenosed left pulmonary artery 9 years after an arterial switch operation and was noted to have an aortopulmonary window about a year later. This was treated with covered stent implantation, which dealt both with the aortopulmonary window and the residual stenosis. The diagnostic process with cardiac magnetic resonance imaging and cardiac catheterization of such an unusual entity as well as the transcatheter management are discussed in detail.
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ABSTRACT: We present a case of an iatrogenic aortopulmonary (AP) fistula in a 9-year-old patient with a history of repaired truncus arteriosus without the use of a right ventricle to pulmonary artery conduit and subsequent transcatheter placement of a right ventricular outflow tract (RVOT) stent. Redilation of the stent resulted in a defect in the aortic wall and the creation of an AP fistula with an associated hemodynamically significant left to right shunt. This case demonstrates a previously unreported adverse event of transcatheter RVOT reintervention after truncus arteriosus repair.The Annals of Thoracic Surgery 09/2014; 98(3):e55-7. DOI:10.1016/j.athoracsur.2014.06.090 · 3.63 Impact Factor