CCCardiol CroatCardiologia CroaticaCardiol. Croat.1848-543X1848-5448Croatian Cardiac SocietyCC_11(10-11)_48810.15836/ccar2016.488Extended AbstractPercutaneous intervention on stenotic extracardiac conduit in a patient with Fontan and dextrocardiahttp://orcid.org/0000-0002-1191-4831GašparovićKristinahttp://orcid.org/0000-0002-8191-3615BridaVojtjehhttp://orcid.org/0000-0003-4596-8261StrozziMajahttp://orcid.org/0000-0002-4497-542XŠmaceljAntonhttp://orcid.org/0000-0002-3437-6407HanževačkiJadranka Šeparovićhttp://orcid.org/0000-0002-7378-944XAnićDarkohttp://orcid.org/0000-0002-1060-0988MalčićIvanhttp://orcid.org/0000-0001-8754-8156BridaMargaritahttp://orcid.org/0000-0002-6910-9720IvanacIrenahttp://orcid.org/0000-0002-8070-1012VečerićSandraUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, CroatiaAddress for correspondence: Kristina Gašparović, Klinički bolnički centar, Kišpatićeva 12, HR-10000 Zagreb, Croatia. / Phone: 385-1-2376-498 / E-mail: tinagasparovic@yahoo.com1120161110-1148848825092016101020162016Croatian Cardiac SocietyKeywords: extracardiac conduitdextrocardiaFontan operation
Introduction: In our country, treatment and follow up of grown-up congenital heart disease patients is limited with relatively low experience and modest diagnostic and therapeutic possibilities. We present a case of a young patient born with complex congenital heart disease corrected with Fontan procedure in childhood, whose medical history was complicated with extracardiac tunnel obstruction.
Case report: Twenty-year-old patient was hospitalized in University Hospital Centre Zagreb for cardiac decompensation manifested with dyspnea, leg edema and ascites. Patient was born with complex congenital heart disease (dextrocardia, “double inlet” left ventricle, pulmonary atresia and great vessels transposition). On her first month, Blalock-Taussig was performed, two years later Glen correction followed and in her eighth year Fontan operation (1) was done. On her regular check-up visit in September 2014, echocardiographic assessment showed her one ventricle (morphologic left) with normal global systolic function and her extracardiac tunnel had normal flow. Eight months later she presented with cardiac decompensation. Multi slice CT (MSCT) angiography and cavography, performed in UHC Zagreb, found calcifications and partial thrombosis of the conduit which was knicked on its mid portion with complete obstruction of the flow. Two weeks later our patient was transferred to Herzzentrum Munich. Dilatation was performed, followed with implantation of three stents and very satisfactory final flow. Clinical status of our patient improved. MSCT angiography showed no residual stenosis on a stented extracardiac conduit.
Conclusion: Dextrocardia, in a patient with complex congenital heart disease, complicated stenting of the extracardiac conduit which was placed between vena cava inferior and pulmonary artery sixteen years earlier and which was knicked on the midportion because it was placed in the heart on the right side. Successful percutaneous intervention was made and three stents implanted. Procedure spared our patient from the fourth cardiotomy.