PMC9912932_01
Ductal angiography showing the restricted pulmonary ductal (orange arrowhead) end and the absence of connection between the branch pulmonary arteries and the pulmonary artery trunk.
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F1
The case was discussed in a multidisciplinary meeting and DS was found more reasonable than surgical valvulotomy (Figure 1).
Stucked stent retrival strategy from the inferior vena cava and transarterial restenting the ductus arteriosus. (A) Ductal pre-dilation with an Ikazuchi coronary balloon 3.0 x 20 mm. (B) Failure to deliver the Dynamic vascular stent within the ductus arteriosus. (C) The stent strutted in the inferior vena cava (green arrowhead). (D) Caval angiography showing no vascular trauma. (E-G) Stent Evacuated through right atrial appendage hybrid access with 20 mm gooseneck snare. (H, I) Transarterial ductal restenting with Resolute Integrity 4.0 x 30 mm stent (red arrowhead). (J) Post-stenting ductal angiography.
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F2
The PDA was pre-dilated with a 3.0 x 20 mm coronary balloon that was inflated to 6 atm (Figure 2A). It was technically impossible to push the stent inside the PDA because of the complex angulation (Figure 2B). The stent got stuck in the IVC upon retrieval (Figure 2C). Caval angiography was done to verify that the IVC was not damaged (Figure 2D). The recapture of the stent was uneventfully performed using a 20 mm gooseneck snare (Figures 2E-G) and DS was successfully performed from the femoral artery with a (4.0 x 30 mm) Resolute Integrity stent that was inflated at 20 atm for 6 s (Figure 2H). Control angiography showed that the stent migrated toward the distal right pulmonary artery (Figures 2H, I). We decided to abort our procedure since the PDA did not close at 3 months of age and the oxygen saturation had already risen to 94% (see Figure 2J).