Coronary stent insertion into a 20-year-old Blalock-Taussig Shunt

A 21 year-old female with complex congenital heart disease presented with declining exercise tolerance, presyncope and increasing cyanosis despite regular venesection. Her double inlet left ventricle with rudimentary right ventricle, restrictive ventricular septal defect and pulmonary stenosis had been managed with a Classic Left Blalock-Taussig (B-T) Shunt aged 2 months and a Modified Right B-T Shunt at 4 years. Aortography revealed a patent but significantly narrowed Left B-T shunt with impaired blood flow and an aneurysmal pulmonary artery. Angioplasty and stenting of the shunt was undertaken and a 4.0 x 12mm coronary stent deployed. The patient's arterial oxygen saturation improved from 76% on pulse oximetry to 85% post procedure and she reported significantly improved exercise tolerance upon follow-up.