Transcatheter Closure of a Coronary Artery Fistula in a Neonate with Tetralogy of Fallot

We present the case of a 32-week premature boy weighing 1.79  kg with TOF, confluent branch pulmonary arteries, major aortopulmonary collaterals, and right coronary artery to main pulmonary artery fistula. The patient demonstrated evidence of coronary steal into the pulmonary vasculature with an elevation in the troponin level without hemodynamic instability , and subsequently underwent successful transcatheter occlusion of the fistula via right common carotid access using a Medtronic 3Q microvascular plug. This case demonstrates the realistic potential for early coronary steal in this physiology and possibility of transcatheter therapy even in a small neonate.
Source: Mammalian Genome - Category: Genetics & Stem Cells Source Type: research