Percutaneous transluminal angioplasty in stenosis of Blalock-Taussig pulmonary systemic shunt in an adult patient

• Published in: Revista medíca de Chile Vol. 121; no. 3; p. 301
• Main Authors: Ramírez, A, Hernández, I, Arcile, G, Farrú, O, Silva, A M, Quispe, P
• Format: Journal Article
• Language: Spanish
• Published: Chile 01-03-1993
• Subjects: Adult; Angioplasty, Balloon, Coronary - methods; Female; Humans; Postoperative Complications - therapy; Pulmonary Artery - surgery; Pulmonary Valve Stenosis - complications; Pulmonary Valve Stenosis - therapy; Subclavian Artery - surgery; Tricuspid Valve - abnormalities
• ISSN: 0034-9887

The report of a female patient with tricuspid atresia and severe stenosis of the pulmonary artery, stenosis of the left pulmonary-systemic shunt and occlusion of the right systemic-pulmonary shunt.
The use of transluminal angioplasty has been extended to the treatment of several congenital cardiopathies and, in some of them, it is the therapeutic procedure of choice.
Dilatation of the distal stenosis of the pulmonary-systemic shunt with a coaxial system composed initially by an 8 French right Judkins carrier catheter with a soft tip through which a 0.014" (0.036 cm) coronary angioplasty guidewire and 3 and 4 mm balloon catheters were advanced successively. Subsequently a 0.028" interchange Rosen guide was advanced, gradually introducing balloon catheters up to 8 mm of diameter.
The dilatation with balloon catheter systems of increasing diameter allowed to amplify the stenosis zone, improving arterial oxygen partial pressure and saturation without evidences of left lung hyperflux. Considering the anatomic characteristics of the pulmonary systemic shunt, the use of carrier catheters facilitates the penetration of balloon catheters to the stenosis zone.
Percutaneous transluminal angioplasty may be used with success in patients with stenosis of Blalock-Taussig shunts, independent of the anastomosis curvature and even if the magnitude of the stenosis is significant.