Abstract
Percutaneous stenting of the pulmonary artery is a diffuse procedure, above all in patients with congenital heart disease. The effectiveness of the procedure is associated with potential and feared complications. This case describes the embolization of a premounted stent into the left lower lobe pulmonary artery in a 3-years old patient with univentricular heart and left-side superior vena cava undergone to Norwood procedure modified according to Sano (stage I) and then bilateral cavo-pulmonary anastomosis according to Glenn (stage II). The retrieval procedures were complicated by the severe hypoplasia of the left pulmonary artery and by the complex anatomy of the patient. This case shows how to pull-back an embolized stent in a child with a complex congenital heart disease despite the limitations related to the low weight and the complex vascular anatomy.
Highlights
Pulmonary artery and its branches stenting is an effective and diffused procedure to treat severe stenosis of these arterial vessels
The effectiveness of the procedure is associated with potential and feared complications. This case describes the embolization of a premounted stent into the left lower lobe pulmonary artery in a 3-years old patient with univentricular heart and left-side superior vena cava undergone to Norwood procedure modified according to Sano and bilateral cavo-pulmonary anastomosis according to Glenn
This case shows how to pull-back an embolized stent in a child with a complex congenital heart disease despite the limitations related to the low weight and the complex vascular anatomy
Summary
Pulmonary artery and its branches stenting is an effective and diffused procedure to treat severe stenosis of these arterial vessels. Ashwath et al published a series of 15 patients weighting less than 10 kilograms underwent percutaneous stenting with a case of a stent embolized to the distal left pulmonary artery and successfully recaptured, it is not explained the technique used to pull-back the stent [6]. At 7 days of life, he underwent Norwood procedure (stage I) modified according to Sano, whereas at 7 months, he was subjected to bilateral cavopulmonary anastomosis according to Glenn (stage II) plus enlargement of the left pulmonary artery with a pericardial patch He was followed periodically through cardiologic visit, electrocardiogram, and echocardiography. Post-operative echocardiogram showed an adequate blood flow into both the right and the left superior vena cava and into the stent placed in the left pulmonary artery
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