Vol. 49 | No. 2 | July-December 2021 Back

Open Access

Ductal Stenting to Retrain the Involuted Left Ventricle in a Late Presenter Infant With Transposition of the Great Arteries, Intact Interventricular Septum

Ma. Rosita S. Quitola, Juan G. Reganion, Jean Antonio G. Villareal
Dec 2021 DOI 10.69944/pjc.d659fc4114

Abstract

INTRODUCTION: Ductal stenting can be a nonsurgical option and less morbid method to  provide pressure and volume overload to the regressing left ventricle in late presenters of  transposition of the great arteries, intact ventricular septum (TGA-IVS), prior to arterial switch  operation (ASO). 

CASE PRESENTATION: This is a case of an infant diagnosed with TGA-IVS beyond the  neonatal period who underwent balloon atrial septostomy and ductal stenting to retrain involuted  left ventricle prior to definitive ASO. 

DISCUSSION: Ductal stenting is an alternative option in late presenters of transposition of the  great arteries with involuted left ventricle. It provides volume loading and, to a lesser extent,  pressure loading leading to left ventricular hypertrophy. Also, presence of the stented duct allows  improved oxygenation eliminating the need for aortopulmonary shunt. It can be a less morbid  method of left ventricular training because it avoids hemodynamic stress, pulmonary artery  distortion, and neoaortic valve regurgitation. 

CONCLUSION: Ductal stenting in late presenters with TGA-IVS successfully retrains the left  ventricle and achieves safe late ASO. 

KEYWORDS: congenital heart disease, transposition of great arteries, PDA stenting, arterial  switch operation 

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