This and that: management of Tetralogy of Fallot and pulmonary vein stenosis in an infant—a case report

Christopher P Scott; Kamel Shibbani; Christopher A Caldarone; Daniel McLennan

doi:10.1093/ehjcr/ytab429

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This and that: management of Tetralogy of Fallot and pulmonary vein stenosis in an infant—a case report

Journal article

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This and that: management of Tetralogy of Fallot and pulmonary vein stenosis in an infant—a case report

Christopher P Scott, Kamel Shibbani, Christopher A Caldarone and Daniel McLennan

European heart journal : case reports, Vol.5(11), p.ytab429

11/01/2021

DOI: 10.1093/ehjcr/ytab429

PMCID: PMC8633749

PMID: 34859184

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Abstract

Abstract Background Tetralogy of Fallot (TOF) is the most common congenital cyanotic cardiac lesion. Pulmonary vein stenosis occurs much less commonly and remains difficult to manage. It is exceedingly uncommon for a patient to have both lesions. This case highlights the diagnostic and management difficulties in an infant with these two lesions. Case summary The patient is a 4-month-old female infant with a history of TOF status post right ventricular outflow tract stent placement who presented after a hypoxaemic event at home to 40% SpO2. Computed tomography angiography demonstrated previously undiagnosed pulmonary vein stenosis of all four veins. She underwent multiple catheter-based palliations including balloon dilations and stent placements in each pulmonary vein in order to maximize her chances of successful definitive repair. She underwent successful repair of her TOF and pulmonary vein stenosis at ten months of age. Discussion The combination of TOF and pulmonary vein stenosis is not common, but when these lesions co-occur, they present a significant dilemma in determining the timing of surgery in order to optimize the odds of a successful outcome. This case demonstrates that serial catheter-based procedures can be valuable tools in minimizing pre-operative risk factors and highlights one strategy in determining timing of definitive surgical repair.

Tetralogy of Fallot

Cardiac catheterization

Case report

Drug-eluting stent

Pulmonary vein stenosis

Details

Title: Subtitle: This and that: management of Tetralogy of Fallot and pulmonary vein stenosis in an infant—a case report
Creators: Christopher P Scott - Division of Pediatric Cardiology, Children’s Wisconsin, 8915 W Connell Ct, P.O. Box 1997, Milwaukee, WI, 53226, USA
Kamel Shibbani - University of Iowa Stead Family Children’s Hospital
Christopher A Caldarone - Texas Children's Hospital
Daniel McLennan - Children's Hospital of Wisconsin
Resource Type: Journal article
Publication Details: European heart journal : case reports, Vol.5(11), p.ytab429
DOI: 10.1093/ehjcr/ytab429
PMID: 34859184
PMCID: PMC8633749
NLM abbreviation: Eur Heart J Case Rep
ISSN: 2514-2119
eISSN: 2514-2119
Publisher: Oxford University Press
Language: English
Date published: 11/01/2021
Academic Unit: Cardiology; Stead Family Department of Pediatrics
Record Identifier: 9984702822502771

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