Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-26T12:01:54.687Z Has data issue: false hasContentIssue false
  • English
  • Français

Transcatheter closure of right pulmonary artery to left atrium fistula in an infant: technical consideration and possible closure techniques

Part of: Interventional Cardiology

Published online by Cambridge University Press:  04 November 2019

Vikas Arya Open the ORCID record for Vikas Arya [Opens in a new window] ,
Sushil Azad  and
Sitaraman Radhakrishnan
Vikas Arya*
Affiliation:
Department of Pediatric Cardiology and Congenital Heart disease, Fortis Escorts Heart Institute, New Delhi, India
Sushil Azad
Affiliation:
Department of Pediatric Cardiology and Congenital Heart disease, Fortis Escorts Heart Institute, New Delhi, India
Sitaraman Radhakrishnan
Affiliation:
Department of Pediatric Cardiology and Congenital Heart disease, Fortis Escorts Heart Institute, New Delhi, India
*
Author for correspondence: V. Arya, Associate Consultant, Department of Pediatric Cardiology and Congenital Heart disease, Fortis Escorts Heart Institute, Okhla, New Delhi 110025, India. Tel: +91 8878312386; Fax: +91 011 47134464. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Congenital right pulmonary artery to left atrium fistula is rare cause of cyanosis. It is an abnormal fistulous connection between right pulmonary artery and left atrium representing a direct communication between a pulmonary artery and vein with absence of capillary network connecting between these two. Cardiovascular examination usually remains normal. High index of suspicion on clinical examination and subsequent transthoracic echocardiography is needed to suspect this entity. Bubble contrast echocardiography usually confirms the diagnosis. Cardiac catheterization is used as diagnostic as well as therapeutic modality. Cardiac catheterization is useful in classifying the fistula and helps in transcatheter closure by embolization devices. Choice of devices depends on type of fistula, vascular access, and presence of atrial communication. Here, we are reporting 8-month-old girl presenting with type 2 right pulmonary artery to left atrium fistula, which underwent successful transcatheter closure by 6 mm/4 mm duct occluder (Heart R, Lifetech Scientific, Shenzhen, China). Early closure in this young age will prevent complications of cyanosis. The technical consideration, possible access, and closure techniques are discussed in this young infant.

Keywords

Congenital right pulmonary artery to left atrium fistulacyanosistranscatheterduct occluder
Type
Brief Report
Information
Cardiology in the Young , Volume 29 , Issue 12 , December 2019 , pp. 1561 - 1564
Copyright
© Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Friedlich, A, Bing, RJ, Blount, SG Jr. Circulatory dynamics in the anomalies of venous return to the heart including pulmonary arteriovenous fistula. Physiol Stud Congenit Hear Dis IX 1950; 86: 20–57.Google ScholarPubMed
Krishnamoorthy, KM, Rao, S. Pulmonary artery to left atrial fistula. Eur J Cardiothorac Surg 2001; 20: 1052–1053.CrossRefGoogle ScholarPubMed
Narula, J, Choudhury, M, Chowdhary, UK, Kiran, U. Pulmonary artery-pulmonary vein fistula: contrast echocardiography using agitated saline for indirect evaluation of adequacy of surgical repair. J Perioper Echocardiog 2014; 2: 61.Google Scholar
Ohara, H, Ito, K, Kohguchi, N, et al. Direct communication between the right pulmonary artery and the left atrium: a case report and review of the literature. J Thorac Cardiovasc Surg 1979; 77: 742–747.10.1016/S0022-5223(19)38227-3CrossRefGoogle ScholarPubMed
Lucas, RV, Lind, GW, Edwards, JE. Direct communication of the pulmonary artery with the left atrium. An unusual variant of pulmonary arteriovenous fistula. Circulation 1961; 24: 1409–1414.10.1161/01.CIR.24.6.1409CrossRefGoogle ScholarPubMed
DeSouza e Silva, NA, Giuciani, ER, Ritter, DG, Davis, GD, Pluth, JR. Communication between right pulmonary artery and left atrium. Am J Cardiol 1974; 34: 857–863.CrossRefGoogle Scholar
Slack, MC, Jedeikin, R, Jones, JS. Transcatheter coil closure of a right pulmonary artery to left atrial fistula in an ill neonate. Catheter Cardiovasc Interv 2000; 50: 330–333.3.0.CO;2-T>CrossRefGoogle Scholar
Francis, E, Sivakumar, K, Kumar, RK. Transcatheter closure of fistula between the right pulmonary artery and left atrium using the Amplatzer duct occluder. Catheter Cardiovasc Interv 2004; 63: 83–86.CrossRefGoogle ScholarPubMed
Uthaman, B, Al-Qbandi, M, Abushaban, L, Rathinasamy, J. Transcatheter closure of large pulmonary arteriovenous fistula including pulmonary artery to left atrial fistula with Amplatzer septal occluder. Catheter Cardiovasc Interv 2007; 70: 422–428.CrossRefGoogle ScholarPubMed
Vadlamudi, K, Verma, S, Christopher, J, Penumatsa, RR, Koneti, NR. Transcatheter closure of large right pulmonary artery-to-left atrial fistula. Ann Pediatr Cardiol 2013; 6: 188.Google ScholarPubMed