Usefulness of balloon angioplasty for the right ventricle‐pulmonary artery shunt with the modified norwood procedure

Abstract

(Word count: 225) Objective: We sought to evaluate the efficacy of balloon angioplasty (BA) for severely desaturated patients due to a stenotic right ventricle (RV) to pulmonary artery (PA) shunt following modified Norwood procedure. Results: BA was performed for stenotic RV-PA shunts following stage I palliation (n=17, 77%), or those placed as an additional blood source (n=5, 23%, 3 patients awaiting biventricular repair, 2 patients following stage II palliation). The location of the BA was at the distal anastomosis in 12 (54.5%), proximal anastomosis in 21 (95.4%) and in the mid-portion of the shunt in 11 (50%) cases. The diameters of these 3 shunt portions were measured from the anterior-posterior and lateral angiographic images, increasing significantly after BA (p<0.0001) in all. Arterial saturation significantly improved after BA in all cases (66.5±4.3% to 79.4±3.4%, p<0.0001). Freedom from reintervention was 100%. All patients underwent subsequent elective planned surgery at an appropriate age Ohno et al. 4 with no mortality.Conclusions: A BA-alone strategy for a stenotic RV-PA shunt was effective for all 3 shunt portions, minimizing shunt-related premature surgical intervention. Ohno et al. 5 BACKGROUND