Pulmonary artery perforation due to off-label stent
This is the case of 13-year-old teenage girl diagnosed with pulmonary atresia with intact ventricular septum treated in the neonatal period with valvulotomy with radiofrequency and percutaneous pulmonary valvuloplasty. Since then, the patient has developed severe pulmonary regurgitation and moderate...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Permanyer
2023-02-01
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| Series: | REC: Interventional Cardiology (English Ed.) |
| Online Access: | https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=915 |
| _version_ | 1811170104198561792 |
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| author | Alejandro Rasines-Rodríguez César Abelleira Pardeiro Enrique José Balbacid Domingo |
| author_facet | Alejandro Rasines-Rodríguez César Abelleira Pardeiro Enrique José Balbacid Domingo |
| author_sort | Alejandro Rasines-Rodríguez |
| collection | DOAJ |
| description | This is the case of 13-year-old teenage girl diagnosed with pulmonary atresia with intact ventricular septum treated in the neonatal period with valvulotomy with radiofrequency and percutaneous pulmonary valvuloplasty. Since then, the patient has developed severe pulmonary regurgitation and moderate tricuspid regurgitation. Valve implantation into the right ventricular outflow tract (RVOT) is decided due to worsening functional class with restrictive behavior of the right ventricle (without anticipated dilatation), and hepatic congestion. Cardiac catheterization reveals the presence of a dilated and pulsatile (pulmonary annulus: 29 mm) RVOT with supravalvular stenosis (minimum diameter: 21 mm), and a 34 mm post-stenotic dilatation (figure 1). A second-staged stent is implanted for percutaneous valve implantation. Given the absence of specific material for RVOTs so dilated, a 30 mm x 40 mm self-expandable Sinus-XL stent (Optimed, Germany) (off-label) is selected for being long enough, easy to implant, having enough navigability for the patient’s age (10-Fr sheath), and requiring less radial strength (favorable for dilated RVOTs). Figure 1. A 14-Fr sheath was used to perform position angiographies (figure 1). A few hours later, the patient showed hemodynamic instability with transthoracic echocardiography findings compatible with cardiac tamponade. An emergency computed tomography scan (figure 2) confirmed the perforation of the pulmonary... |
| first_indexed | 2024-04-10T16:51:56Z |
| format | Article |
| id | doaj.art-5aacb815416349a4a2653583ebd89f17 |
| institution | Directory Open Access Journal |
| issn | 2604-7322 |
| language | English |
| last_indexed | 2024-04-10T16:51:56Z |
| publishDate | 2023-02-01 |
| publisher | Permanyer |
| record_format | Article |
| series | REC: Interventional Cardiology (English Ed.) |
| spelling | doaj.art-5aacb815416349a4a2653583ebd89f172023-02-07T15:20:38ZengPermanyerREC: Interventional Cardiology (English Ed.)2604-73222023-02-0151878810.24875/RECICE.M22000316Pulmonary artery perforation due to off-label stentAlejandro Rasines-Rodríguez0César Abelleira Pardeiro1Enrique José Balbacid Domingo2Servicio de Cardiología Infantil, Sección de Hemodinámica Infantil, Hospital Universitario La Paz, Madrid, SpainServicio de Cardiología Infantil, Sección de Hemodinámica Infantil, Hospital Universitario La Paz, Madrid, SpainServicio de Cardiología Infantil, Sección de Hemodinámica Infantil, Hospital Universitario La Paz, Madrid, SpainThis is the case of 13-year-old teenage girl diagnosed with pulmonary atresia with intact ventricular septum treated in the neonatal period with valvulotomy with radiofrequency and percutaneous pulmonary valvuloplasty. Since then, the patient has developed severe pulmonary regurgitation and moderate tricuspid regurgitation. Valve implantation into the right ventricular outflow tract (RVOT) is decided due to worsening functional class with restrictive behavior of the right ventricle (without anticipated dilatation), and hepatic congestion. Cardiac catheterization reveals the presence of a dilated and pulsatile (pulmonary annulus: 29 mm) RVOT with supravalvular stenosis (minimum diameter: 21 mm), and a 34 mm post-stenotic dilatation (figure 1). A second-staged stent is implanted for percutaneous valve implantation. Given the absence of specific material for RVOTs so dilated, a 30 mm x 40 mm self-expandable Sinus-XL stent (Optimed, Germany) (off-label) is selected for being long enough, easy to implant, having enough navigability for the patient’s age (10-Fr sheath), and requiring less radial strength (favorable for dilated RVOTs). Figure 1. A 14-Fr sheath was used to perform position angiographies (figure 1). A few hours later, the patient showed hemodynamic instability with transthoracic echocardiography findings compatible with cardiac tamponade. An emergency computed tomography scan (figure 2) confirmed the perforation of the pulmonary...https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=915 |
| spellingShingle | Alejandro Rasines-Rodríguez César Abelleira Pardeiro Enrique José Balbacid Domingo Pulmonary artery perforation due to off-label stent REC: Interventional Cardiology (English Ed.) |
| title | Pulmonary artery perforation due to off-label stent |
| title_full | Pulmonary artery perforation due to off-label stent |
| title_fullStr | Pulmonary artery perforation due to off-label stent |
| title_full_unstemmed | Pulmonary artery perforation due to off-label stent |
| title_short | Pulmonary artery perforation due to off-label stent |
| title_sort | pulmonary artery perforation due to off label stent |
| url | https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=915 |
| work_keys_str_mv | AT alejandrorasinesrodriguez pulmonaryarteryperforationduetoofflabelstent AT cesarabelleirapardeiro pulmonaryarteryperforationduetoofflabelstent AT enriquejosebalbaciddomingo pulmonaryarteryperforationduetoofflabelstent |