Early postinterventional stent stenosis of a ductus stent implanted for palliation in a newborn with pulmonary atresia with intact ventricular septum: Successful management with bailout stenting

A newborn with pulmonary atresia with intact ventricular septum (PA-IVS) wa s treated with radiofrequency current perforation of the atretic pulmonary valve. As the right ventricle was hypoplastic (z-value of the tricuspid val ve: -4) the arterial duct was stented with a Gianturco-Roubin GR If stent. Early postinterventionally, the patient became cyanotic and compromised blo od flow across the stented ductus arteriosus despite adequate stent positio n was detected echographically. The newborn was treated sucessfully with th e implantation of a Palmaz stent (Johnson gi Johnson Interventional Systems , Warren, NJ, USA) into the obstructed Gianturco-Roubin GR II stent. The Gi anturco-Roubin GR II stents might be associated with the risk of early sten t stenosis after implantation in actively contracting tissues like the duct us arteriosus. In patients with early stent stenosis after ductal stenting, bailout implantation of a subsequent stent can be performed. Transcatheter procedures can be effective means for therapy of PA-IVS.