Percutaneous treatment of partial anomalous pulmonary venous connection with dual drainage. Case resolution

Abstract

CASE RESOLUTION The heart team decision was to percutaneously treat both the coronary artery disease and the partial anomalous pulmonary venous connection (PAPVC). Percutaneous coronary intervention was successfully performed in the first place. Treatment of the PAPVC was performed 3 months later. Since it is recommended that the diameter of the device should be 30% to 50% larger than the vessel diameter, a 22 mm Amplatzer Vascular Plug II device (AVP-II) (Abbott, United States) was selected based on the VV computed tomography measurements. The procedure was performed under local anesthesia and with fluoroscopic control. A 7-Fr introducer sheath was inserted into the right femoral vein. A 6-Fr multipurpose diagnostic catheter was advanced using a 0.035 in exchange guidewire to reach the VV through the left innominate vein (figure 1A). Angiography confirmed the presence of a left upper pulmonary vein (LUPV) with dual drainage and significant contrast flow from the LUPV to the innominate vein that filled the right chambers (left-to-right shunt) (figure 1, video 1 of the supplementary data). Using a femoral 7-Fr 90 cm Destination Guiding Sheath (Terumo, United States) the AVP-II device was placed and delivered into the VV (figure 2A, video 2 of the supplementary data). The correct position,...