ABSTRACT
A 2-month-old infant presented with acute onset of heart failure, having previously undergone anatomical repair of transposition of the great arteries and ventricular septal defect (VSD). Echocardiography demonstrated aneurysmal dilation of the native pericardial patch used for VSD closure, resulting in right ventricular inflow obstruction. The pericardial patch was excised, and the VSD closed using a GoreTex patch.
Subject(s)
Pericardium/transplantation , Surgical Flaps/adverse effects , Transposition of Great Vessels/surgery , Ventricular Outflow Obstruction/surgery , Aneurysm, False/diagnostic imaging , Cardiac Surgical Procedures/adverse effects , Cardiac Surgical Procedures/methods , Echocardiography, Doppler , Follow-Up Studies , Heart Septal Defects, Ventricular/diagnostic imaging , Heart Septal Defects, Ventricular/surgery , Humans , Infant , Male , Pulmonary Valve Stenosis/complications , Reoperation , Transposition of Great Vessels/complications , Transposition of Great Vessels/diagnostic imaging , Treatment Outcome , Ventricular Outflow Obstruction/diagnostic imaging , Ventricular Outflow Obstruction/etiologyABSTRACT
Transcatheter fenestration and balloon dilation of an atrial baffle created from native atrial tissue was attempted in a 15-year-old girl with failing Fontan physiology and protein-losing enteropathy. After transseptal puncture, initial dilations with a 10-mm and 12-mm diameter balloon resulted in an inadequate fenestration, with no significant decrease of right atrial pressure or systemic arterial saturation. Dilation of the fenestration with a 16-mm-diameter balloon produced a tear of the atrial septum and subsequent death. Balloon dilation of native atrial tissue may result in uncontrolled tears of the atrial septum.
