Staged Treatment Using Right Ventricular Outflow Tract Stenting for Effective Augmentation of Native Pulmonary Arteries in a Case of Tetralogy of Fallot with Major Aortopulmonary Collateral Arteries

Abstract

Stenting of the right ventricular outflow tract (RVOT) is an emerging alternative for the management of cyanotic tetralogy of Fallot (TOF) in the neonatal or early infancy stage. We describe our treatment of a TOF in the early infancy stage, using RVOT, in a patient for whom the TOF physiology was associated with major aortopulmonary collateral arteries (MAPCAs), all of which had a dual blood supply from the pulmonary arteries. The procedure was successful, with sufficient antegrade blood flow of the native pulmonary arteries achieved for occlusion of all MAPCAs. RVOT stenting provided an effective strategy for the management of cyanotic TOF, without the need for unifocalization, in the presence of MAPCAs with dual blood supply.