Stenting Of Branch Pulmonary Artery In An Adult Patient With Repaired Tetrology Of Fallot With Right Pulmonary Artery Origin Stenosis: A Case Report

Abstract

Now a days due to improved paediatric cardiac care we see patients with repaired or unrepaired
congenital heart diseases in adult age more often. Pulmonary artery (PA) stenosis is a common
association with Tetrology of Fallot (TOF). It is common to see some degree of residual pulmonary
artery stenosis post intra cardiac repair. These stenosis can, sometimes, progress and present in
adulthood. Management of patients with peripheral or branch PA stenosis have primarily been
catheterization with surgical management of these cases reserved for limited indications. Here we
report a case of Right PA ostial stenosis in an adult patient with history of surgical correction of TOF in
childhood. We also describe the procedural aspects in the correction of this defect. We here discuss the
indications, contraindications and complications of transcatheter and surgical approach. Lack of
practice guidelines and recommendations with respect to patient selection, hardware selection, follow
up, antiplatelet regimen and operative hemodynamics makes this procedure difficult to learn, monitor
and follow.