Multimodal Imaging to Guide Stent Placement in a Patient After Fontan Palliation With Restrictive Interatrial Communication

Q4 Medicine

JACC. Case reports Pub Date : 2025-06-25 DOI:10.1016/j.jaccas.2025.104115

Daniel S. Schwab MD, Patcharapong Suntharos MD, Nicholas A. Szugye MD, MSc

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Abstract

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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多模态成像指导限制性心房间沟通方坦姑息患者支架置入

目的房间通讯受限是单脑室生理患者中一种罕见的并发症，它阻碍了肺静脉流向系统脑室。通常经皮房间隔球囊成形术或房间隔支架置入术治疗，这是一项具有技术挑战性的任务。多期采集心脏计算机断层扫描和术中经食管超声心动图的专业后处理有助于规划和成功放置支架，降低左房压，缓解肺静脉流出梗阻。潜在的缺陷除了增加手术前的时间和可能需要额外的麻醉外，该手术没有预期的缺陷。多模态手术前成像和先进的三维重建可以为复杂先天性心脏病患者的经皮介入治疗计划提供手术设计。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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