{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T23:10:00Z","timestamp":1740179400498,"version":"3.37.3"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T00:00:00Z","timestamp":1573603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Adults with complex congenital heart disease palliated with systemic-to-pulmonary artery shunts have become rare and represent a particularly challenging patient group for the cardiologist. One of the complications and causes of severe clinical deterioration during long-term follow-up are progressive obstruction or total occlusion of the shunt. The risk for surgical intervention is frequently high and catheter intervention may be complicated by complex anatomy and shunt calcification.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We report the case of a 47-year-old man with uncorrected (palliated) pulmonary atresia and ventricular septal defect who presented with progressive cyanosis (oxygen saturation 69%) and decreasing exercise capacity. Computed tomography revealed a totally occluded modified left Blalock\u2013Taussig (BT) shunt and a severely stenosed central shunt (Waterston\u2013Cooley) in a patient with confluent but hypoplastic pulmonary arteries and multiple major aortic pulmonary collaterals. Due to a high operative risk, an interventional, percutaneous approach was preferred to re-do surgery. From a radial access the calcified BT shunt could be crossed with a hydrophilic guidewire. Then, a rotational thrombectomy, balloon dilatation, and bare-metal stenting at the proximal and distal anastomoses were performed. Post-interventionally, peripheral oxygen saturation increased from 69% to 82%. Clopidogrel was administered for 1 month after bare-metal stenting. At 1-year follow-up, the BT shunt was still patent on echocardiography and exercise tolerance markedly improved.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This case highlights the benefit of percutaneous rotational thrombectomy followed by stenting of chronically occluded systemic-to-pulmonary artery shunts for further palliation in adult patients with complex congenital heart disease not suitable for surgical repair.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytz201","type":"journal-article","created":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T16:33:01Z","timestamp":1573662781000},"page":"1-4","source":"Crossref","is-referenced-by-count":1,"title":["Stenting of modified Blalock\u2013Taussig shunt in adult with palliated pulmonary atresia and ventricular septal defect: a case report"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1277-9205","authenticated-orcid":false,"given":"Julia","family":"Illner","sequence":"first","affiliation":[{"name":"Department of Cardiology I: Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holger","family":"Reinecke","sequence":"first","affiliation":[{"name":"Department of Cardiology I: Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helmut","family":"Baumgartner","sequence":"first","affiliation":[{"name":"Department of Cardiology III: Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8782-0401","authenticated-orcid":false,"given":"Gerrit","family":"Kaleschke","sequence":"first","affiliation":[{"name":"Department of Cardiology III: Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,11,13]]},"reference":[{"key":"2020021801594633000_ytz201-B1","doi-asserted-by":"crossref","first-page":"425","DOI":"10.4103\/0972-5229.186248","article-title":"Systemic thrombolysis with recombinant tissue plasminogen activator for acute life-threatening Blalock-Taussig shunt obstruction","volume":"20","author":"Diaz","year":"2016","journal-title":"Indian J Crit Care Med"},{"key":"2020021801594633000_ytz201-B2","first-page":"743","article-title":"Emergency transcatheter balloon recanalization of acutely thrombosed modified Blalock-Taussig shunts","volume":"53","author":"Sivakumar","year":"2001","journal-title":"Indian Heart J"},{"key":"2020021801594633000_ytz201-B3","doi-asserted-by":"crossref","DOI":"10.1136\/bcr.2006.105296","article-title":"Stenting of a stenosed modified Blalock\u2013Taussig shunt after Norwood-I palliation for hypoplastic left heart","volume":"2009","author":"Krasemann","year":"2009","journal-title":"BMJ Case Rep"},{"key":"2020021801594633000_ytz201-B4","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1017\/S1047951111000254","article-title":"Stenting of modified and classical Blalock\u2013Taussig shunts\u2014lessons learned from seven consecutive cases","volume":"21","author":"Krasemann","year":"2011","journal-title":"Cardiol Young"},{"key":"2020021801594633000_ytz201-B5","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1007\/s00246-014-1086-0","article-title":"Catheter-based interventions for modified Blalock-Taussig shunt obstruction: a 20-year experience","volume":"36","author":"Bonnet","year":"2015","journal-title":"Pediatr Cardiol"},{"key":"2020021801594633000_ytz201-B6","first-page":"164","article-title":"A case of percutaneous modified Blalock-Taussig shunt downsize with multiple stent-in-graft technique","volume":"12","author":"Fiszer","year":"2016","journal-title":"Adv Interv Cardiol"},{"key":"2020021801594633000_ytz201-B7","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1177\/2150135115603332","article-title":"Interventions involving the use of covered coronary artery stents for pseudoaneurysms of Blalock-Taussig shunts","volume":"7","author":"Baspinar","year":"2016","journal-title":"World J Pediatr Congenit Heart Surg"},{"key":"2020021801594633000_ytz201-B8","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1002\/ccd.1210","article-title":"Recanalization and thrombectomy of internal anastomosis in a patient with tetralogy of Fallot using the AngioJet rheolytic catheter","volume":"53","author":"Kokov","year":"2001","journal-title":"Cathet Cardiovasc Intervent"},{"key":"2020021801594633000_ytz201-B9","doi-asserted-by":"crossref","first-page":"213","DOI":"10.4103\/0974-2069.140855","article-title":"Angiojet thrombectomy for Blalock-Taussig shunt and pulmonary artery thrombus in an infant with tetralogy of fallot","volume":"7","author":"Wehman","year":"2014","journal-title":"Ann Pediatr Card"},{"key":"2020021801594633000_ytz201-B10","first-page":"218.","article-title":"Coronary stent insertion into a 20-year-old Blalock-Taussig shunt","volume":"99","author":"Maree","year":"2006","journal-title":"Ir Med J"},{"key":"2020021801594633000_ytz201-B11","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1111\/j.1747-0803.2010.00469.x","article-title":"63-year survival after Blalock-Taussig shunt operation in a patient with single ventricle, tricuspid atresia, and pulmonary stenosis","volume":"6","author":"Scholtz","year":"2011","journal-title":"Congenit Heart Dis"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/3\/4\/1\/32501098\/ytz201.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/3\/4\/1\/32501098\/ytz201.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T01:59:55Z","timestamp":1581991195000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/3\/4\/1\/5625094"}},"subtitle":[],"editor":[{"given":"Jonathan M.","family":"Behar","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Esther","family":"Cambronero-Cortinas","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Rizwan","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Mohammed Majid","family":"Akhtar","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Peysh A","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2019,11,13]]},"references-count":11,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,11,13]]},"published-print":{"date-parts":[[2019,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytz201","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2019,12]]},"published":{"date-parts":[[2019,11,13]]}}}