After inserting a 12 Fr sheath through right femoral
vein, Pig-tail catheter was advanced into the right pulmonary artery (RPA).
Right pulmonary angiogram showed a critical stenosis at the proximal segment
of RPA ( Figure
3). The main pulmonary systolic and mean arterial pressures were 70mmHg
and 39mmHg, respectively. The distal RPA systolic and mean arterial pressures
were 55mmHg and 36mmHg, respectively. Because of the morphological stenosis
and pressure step-up, we intended to treat the lesion with stenting. After
advancement of 11 Fr Mullin sheath into the RPA,(Figure
4) a 16x40mm Wall stent (Wall stent UNI, Boston Scientific) was positioned
to cover the lesion.(Figure
5) Angiogram after stent deployment showed residual indentation in the
middle portion of the stent.(Figure
6) Therefore, additional balloon dilatation was performed with a 18x20mm
(XXL balloon, Boston Scientific) balloon (Figure
7). Final angiogram showed a very good result.( Figure
8) The main pulmonary systolic and mean arterial pressures were decreased
to 41mmHg and 29mmHg, respectively. |
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