Pediatric Cardiology and Cardiac Surgery
Vol.26 No.5 2010 (423-427)

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Toshikatsu Tanaka,1) Hirofumi Saiki,1) Kenta Tominaga,1) Hideki Fujita,1) Sachiko Kido,1) and Yoshihiro Oshima2)

Departments of 1)Cardiology and 2)Cardiovascular Surgery, Hyogo Prefectural Kobe Children’s Hospital, Kobe, Japan


A 14-year-old girl with a double outlet right ventricle with pulmonary atresia and patent ductus arteriosus had undergone a Rastelli operation and pulmonary artery plasty at the age of 4 years and was diagnosed with bilateral pulmonary artery stenosis using echocardiography. Cardiac catheterization demonstrated that the right ventricular pressure was 56% of that in the left ventricle due to bilateral pulmonary artery stenosis. Balloon angioplasty (BAP) was performed using a high-pressure balloon for bilateral lesions. Soon after dilation of the right pulmonary artery, her arterial oxygen saturation dropped from 100 to 90%. A right pulmonary artery angiogram showed direct communication to the left atrium. Although traumatic right pulmonary artery to left atrium communication as a complication of BAP is very rare, attention should be paid when performing this procedure.