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Unexpected ischemia during transcatheter patent arterial duct closure

Part of: Interventional Cardiology

Published online by Cambridge University Press:  23 September 2019

Ondrej Materna Open the ORCID record for Ondrej Materna [Opens in a new window] ,
Vojtech Suchanek  and
Oleg Reich
Ondrej Materna*
Affiliation:
Children’s Heart Centre, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
Vojtech Suchanek
Affiliation:
Department of Radiology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
Oleg Reich
Affiliation:
Children’s Heart Centre, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
*
Author for correspondence: O. Materna, MD, FN Motol, Dětské kardiocentrum, V Úvalu 84, 150 06, Prague 5, Czech Republic. Tel: +420224432991; Fax: + 420224432915; E-mail: ondrej.materna@fnmotol.cz
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Abstract

A child undergoing routine transcatheter patent arterial duct closure developed severe transient ischemic changes in the electrocardiogram (Pardee waves) while the aortic retention skirt of the Amplatzer™ Duct Occluder was pulled against the duct orifice. The occluder was then released, and the delivery system was pulled back to inferior caval vein which led to electrocardiogram normalisation. Aortic root angiography showed a single coronary artery originating from the right sinus of Valsalva with the left coronary stem wedged behind the posterior aspect of the right ventricular outflow tract. We believe that the left coronary artery was compressed while applying tension on the occluder delivery system.

Keywords

Patent arterial ducttranscatheter closurecoronary anomalymyocardial ischemia
Type
Brief Report
Information
Cardiology in the Young , Volume 29 , Issue 11 , November 2019 , pp. 1410 - 1411
Copyright
© Cambridge University Press 2019 

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References

Villa, ADM, Sammut, E, Nair, A, Rajani, R, Bonamini, R, Chiribiri, A. Coronary artery anomalies overview: the normal and the abnormal. World J Radiol 2016; 8: 537–555.CrossRefGoogle ScholarPubMed
Dotan, M, Roguin, A, Sinyor, D, et al. Increased incidence of coronary artery origin anomalies associated with isolated patent ductus arteriosus. Pediatr Cardiol 2013; 34: 907.CrossRefGoogle ScholarPubMed
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