Recanalisation of subclavian-pulmonary artery shunt in adult with tetralogy of Fallot

BMJ Case Rep. 2019 Jul 27;12(7):e229144. doi: 10.1136/bcr-2018-229144.

Abstract

We report the case of a patient diagnosed with extreme tetralogy of Fallot who received subclavian-pulmonary artery shunt at the age of 3 years and underwent corrective surgery at the age of 16 years. The patient developed progressive effort dyspnea and left ventricular dysfunction from the age of 40 years. The exploratory finding of a continuous jugular and left subclavian murmur prompted an echocardiographic study that evidenced a continuous flow in the suprasternal view. CT study confirmed the patency of the surgical subclavian-pulmonary artery shunt, which was percutaneously embolised with the implantation of an Amplatzer plug, with a good final outcome and no residual flow. The patient showed a satisfactory development with clinical improvement, decreased left ventricular volume and enhanced left ventricular function.

Keywords: clinical diagnostic tests; heart failure; interventional cardiology; ultrasonography.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blalock-Taussig Procedure*
  • Dyspnea / etiology*
  • Electrocardiography
  • Embolization, Therapeutic*
  • Humans
  • Male
  • Pulmonary Artery / physiopathology
  • Pulmonary Artery / surgery
  • Subclavian Artery / physiopathology
  • Subclavian Artery / surgery
  • Tetralogy of Fallot / complications*
  • Tetralogy of Fallot / physiopathology
  • Treatment Outcome
  • Vascular Patency / physiology*
  • Ventricular Dysfunction, Left / etiology*
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Left / surgery