Abstract
BackgroundBlalock-Taussig shunt (BTS) continues to have a relatively high operative and short-term mortality, even in the current era. We report the use of drug-eluting stent in a child with acute shunt thrombosis, which has not been reported in the literature to date.Case presentationA 7-month-old boy with double outlet right ventricle, severe pulmonary stenosis, and normally related great arteries underwent BTS placement for cyanotic spells. Ten days after discharge, he presented with shock due to a blocked BTS. He underwent emergency percutaneous revascularization of the shunt with a drug-eluting stent and is doing well at 9 months’ follow-up on dual antiplatelet therapy.ConclusionsDrug-eluting stents may be used in children with BTS thrombosis.
Highlights
BackgroundThe outcomes of congenital heart diseases have considerably improved over the past two decades following improvements in surgical techniques, interventions, and intensive care
Blalock-Taussig shunt (BTS) continues to have a relatively high operative and short-term mortality, even in the current era
We report the use of drug-eluting stent in a child with acute shunt thrombosis, which has not been reported in literature till date
Summary
The outcomes of congenital heart diseases have considerably improved over the past two decades following improvements in surgical techniques, interventions, and intensive care. Systemic to pulmonary artery shunt occlusion constitutes an emergency where timely intervention can be lifesaving. Case presentation A 7-month-old boy weighing 6 kg was admitted to the intensive care with cyanotic spell. He was diagnosed to have double outlet right ventricle with severe pulmonary stenosis and normally related great arteries. He was stabilized with intravenous morphine, ketamine, and esmolol infusion. The blocked shunt was predilated with a 4 mm × 8 mm non-compliant balloon at 10 atm following which a 4 mm × 18 mm sirolimus-eluting stent was deployed at nominal pressures covering both ends of the shunt (Fig. 1). Aspirin was Gopalakrishnan et al The Egyptian Heart Journal (2020) 72:54
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