Vol. 40 | No. 1 | January-June 2012 Back

Open Access

Ductal Stenting Through the Left Internal Carotid Artery in a 5-Year Old Male with PVA: A Case Report

Dexter D. Cheng, Olympia Q. Malanyaon, Jose Jonas Del Rosario, Andrea Orel Valle, Maycibel Capero, Bee Jane T. Martinez
Jun 2012 DOI 10.69944/pjc.a88095f56d

Abstract

Patients diagnosed with Tetralogy of Fallot (TOF) with Pulmonary Vavle Atresia (PVA) are dependent on a persistent ductus arteriosus (PDA) or collaterals for continued pulmonary blood flow and oxygenation. If collateral flow or the PDA flow is insufficient, a modified Blalock-Taussig shunt (mBTS) is a necessary step to stimulate the growth of the pulmonary arteries prior to placement of a conduit from the right ventricle to the pulmonary arteries. Stenting of a restricted PDA is now widely considered a viable alternative to mBTS. However, this procedure is more commonly performed in the neonatal period. This is followed by total correction via open heart surgery, and may be done in a young child. In a developing nation, ideal cardiac repair is not always feasible. We successfully carried out ductal stenting via the left internal carotid artery in a 5-year old male patient diagnosed with TOF, PVA with a restrictive vertically positioned PDA supplying the pulmonary arteries and no other collateral blood flow. He had severely decreased oxygen saturation prior to ductal stenting which increased to 85 % from 52% after the procedure. This is the first reported case of the performance of ductal stenting via the left internal carotid artery in an older child in the Philippines. This report demonstrates that ductal stenting in older children, like those in neonates, can also be safely and effectively performed. 

KEY WORDS ductal stenting, left internal carotid artery, fluoroscopy, modified Blalock-Taussig shunt, PVA, ductus arteriousus, tetralogy of Fallot

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