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Multimodal Imaging to Guide Stent Placement in a Patient After Fontan Palliation With Restrictive Interatrial
Daniel S Schwab1, Patcharapong Suntharos1, Nicholas A Szugye1
1Cleveland Clinic Children's, Cleveland, Ohio, USA.
Objective:
Late interatrial communication restriction is a rare complication in patients with single-ventricle physiology, obstructing pulmonary venous flow to the systemic ventricle. It is commonly treated percutaneously with balloon atrial septoplasty or atrial septum stenting, a technically challenging task.
Key Steps:
Preprocedural specialized postprocessing of multiphase acquisition cardiac computed tomography and intraprocedure transesophageal echocardiography allowed for planning and successful stent placement, reducing left atrial pressure and relieving pulmonary venous outflow obstruction.
Potential Pitfalls:
Aside from the increased preprocedural time and possible need for additional anesthesia, there are no pitfalls anticipated with this procedure.
Take-Home Message:
Multimodality preprocedural imaging and advanced three-dimensional reconstruction can provide a procedural design when planning percutaneous intervention in patients with complex congenital heart disease.
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