Critical value of the balloon occlusion test of a coronary fistula in a patient with pulmonary atresia and intact ventricular septum (RCD code: I‐1C.4;­ II‐2A.1)

Jacek Kuźma, Piotr Weryński, Paweł Skorek, Marek Rączka, Katarzyna Konarska

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Abstract


We present the case of a boy with pulmonary atresia (PA), intact ventricular septum (IVS), and a coronary fistula between the right ventricle (RV) and a single left coronary artery (SLCA). In the newborn period, the child was operated on using a right Blalock–Taussing shunt (RBTS). At the age of 6 months, he was admitted to the department of Paediatric Cardiology due to hypoxaemia and cardiac catheterisation was performed before qualification for cardiac surgery. During haemodynamic evaluation of the patient, we conducted the balloon occlusion test of the coronary fistula and demonstrated that coronary circulation depends on the wide fistula and high pres‐
sure in the RV. We decided not to perform embolisation of the fistula and qualified the child for bidirectional Glenn palliation without RV decompression. The balloon occlusion test in patients with coronary fistulas plays a critical role and its result can be crucial for further management of the patient. JRCD 2019; 4 (3): 55-58.


Keywords


pulmonary atresia with intact ventricular septum; single coronary ostium; coronary fistula; balloon occlusion test

References


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Powell AJ, Mayer JE, Lang P, et al. Outcome in infants with pulmonary atresia, intact ventricular septum, and right ventricle‐dependent coronary circulation. Am J Cardiol 2000; 86: 1272–1274.

Rychik J, Levy H, Gaynor JW, et al. Outcome after operation for pulmonary atresia with intact ventricular septum. J Thorac Cardiovasc Surg. 1998; 116:924–31.

Foker JE, Setty SP, Berry J, et al. Treatment of right ventricle to coronary artery connections in infants with pulmonary atresia and intact ventricular septum. J Thorac Cardiovasc Surg 2008;136(3):749–756.

Garabedian CP, Mosca RS, Hellenbrand WE. Coronary artery fistula embolization in an infant with pulmonary atresia intact ventricular septum: a case report. Catheter Cardiovasc Interv 2002; 57(3):371–373.




DOI: http://dx.doi.org/10.20418%2Fjrcd.vol4no3.357

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