ABSTRACT
BACKGROUND: Balloon angioplasty is a useful therapeutic method in some congenital heart diseases. We show our experience of stenotic Blalock-Taussig angioplasty, which was effective in six cases. PATIENTS AND METHODS: Six symptomatic patients with different congenital heart diseases, reduced pulmonary blood flow and a previous Blalock-Taussig shunt (it was classic in three patients and modified in another three) underwent the procedure. Conventional angioplasty was performed in four cases and coronary angioplasty technique, under monorail system, was applied in the other two. RESULTS: After angioplasty, we observed an increase in the minimum luminal diameter from 1 +/- 0.7 to 4 +/- 0.5 mm (p < 0.01), a reduction in the percentage of the stenosis from 77 +/- 15 to 13 +/- 13 (p < 0.01) and an increase in oxygen saturation from 63 +/- 10% to 82 +/- 5% (p < 0.05). The effectiveness of the technique in an extreme case of a thrombosed Blalock-Taussig, hours later the surgery, is reported. In the follow-up, we observed a symptomatic improvement, stable oxygenation levels, and a tendency in the hematocrit reduction. CONCLUSION: We consider that angioplasty of Blalock-Taussig shunt is indicated in those symptomatic patients, in whom a complete surgical correction is contraindicated. We demonstrate the effectiveness of the procedure, the coronary angioplasty, under monorail system is very useful for the stenotic modified Blalock-Taussig. It can be an effective technique when there is a postoperative thrombosis of the fistula.
Subject(s)
Anastomosis, Surgical/adverse effects , Angioplasty, Balloon , Arterial Occlusive Diseases/therapy , Heart Defects, Congenital/surgery , Pulmonary Artery , Subclavian Artery , Anastomosis, Surgical/methods , Arterial Occlusive Diseases/etiology , Child , Child, Preschool , Constriction, Pathologic/etiology , Constriction, Pathologic/therapy , Female , Humans , Infant , Male , Pulmonary Artery/surgery , Subclavian Artery/surgeryABSTRACT
We report a case of one young patient with symptoms of palpitations and ventricular and supraventricular arrhythmias documented in the 24-hours Holter record. He had a deformity of silhouette and pericardial calcification in the chest roentgenogram. In the computed tomography and the magnetic resonance employed in the evaluation of structural anomalies, dates compatible with ventricular herniation, across one parcel of pathologically calcified pericardium, were present. The probable etiology, operatory findings and the management of those patients are discussed.
