Internal mammary artery as a palliative systemic-pulmonary shunt in order to develop diminutive pulmonary arteries

Diminutive pulmonary arteries remain a problem in the surgery of congenital heart disease. This is the second report of a case in which the internal mammary artery was successfully used to enlarge small pulmonary arteries by 50% within 9 months accompanied by improvement of the symptomatic state in a patient with pulmonary atresia and diminutive left pulmonary arteries.