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

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...

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Bibliographic Details
Published in:Cardiology in the young 2019-12, Vol.29 (12), p.1561-1564
Main Authors: Arya, Vikas, Azad, Sushil, Radhakrishnan, Sitaraman
Format: Article
Language:English
Subjects:
Atria
Atrium
Cardiac catheterization
Cardiac Catheterization - methods
Cardiology
Cardiovascular disease
Catheterization
Complications
Cyanosis
Cyanosis - etiology
Diagnostic systems
Echocardiography
Embolization
Female
Fistula
Fistula - complications
Fistula - congenital
Fistula - diagnostic imaging
Fistula - surgery
Fistulae
Heart
Heart Atria
Humans
Infant
Pediatrics
Pulmonary arteries
Pulmonary artery
Pulmonary Artery - abnormalities
Pulmonary Artery - diagnostic imaging
Pulmonary Artery - surgery
Treatment Outcome
Veins & arteries
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Summary: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.
ISSN:1047-9511
1467-1107
DOI:10.1017/S1047951119002592