Case Report a Patient with Tetralogy of Fallot and Use of Sent for Severe Distal RPA Stenosis

سال انتشار: 1398
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 392

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شناسه ملی سند علمی:

CTOG03_002

تاریخ نمایه سازی: 30 مهر 1398

چکیده مقاله:

Introduction: Using stent for relieve of stenosis of pulmonary branches after surgical correction had known as choice method. We present a patient with Tetralogy of Fallot that she had severe stenosis in distal right pulmonary artery at the site of BT shunt that was very difficult to pass guide wire through it. A girl three years old, known case of TOF from early life. She had history of frequent hyper cyanotic spells and candidate for RVOT stenting in 2.5 years ago, but stent moved to IVC and extracted with surgery and she had history of three times surgery, including right and left BT shunt and then TC and shunt take down. In physical exam she had no cyanosis and clubbing. She had normal pulses, no heave or thrill, normal S1, single S2 and a systolic murmur grade II- III/VI in LSB. In electrocardiography normal sinus rhythm, right axis deviation and right bundle branch block exist. In chest X Ray heart size was increased and pulmonary vascular marking was decreased in right lung. In echocardiography small residual ventricular septal defect and dilated right atrium and ventricle with moderate tricuspid regurgitation, moderate right pulmonary artery stenosis. In angiography of right ventriculography showed severe TR, dilated MPA and severe distal RPA stenosis at the previous right BT shunt. After balloon pre dilatation of RPA stenosis with coronary balloon 5*15 and Power flex 6*20, the delivery system was passed into RPA and stenting of RPA with FORMULA stent 10*20 was done successfully. RV and PA injection after stenting showed good flow and increased diameter of RPA. Conclusion: Use of stent for distal stenosis of pulmonary artery branches is choice and using of coronary and Power flex balloon before use of stent is suitable for passing guide wire and deploy stent in a nice position especially in severe distal pulmonary branch stenosis.

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نویسندگان

Alireza Ahmadi

Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

Mehdi Ghaderian

Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran