Percutaneous obliteration of left ventricular cavity to eliminate aortic regurgitation and presumed coronary steal in an infant with hypoplastic left heart syndrome

Catheter Cardiovasc Interv. 2017 Nov 15;90(6):982-985. doi: 10.1002/ccd.27138. Epub 2017 Jun 1.

Abstract

The phenomenon of coronary steal is well known in the setting of HLHS (Hypoplastic Left Heart Syndrome) early after the Classical Norwood Operation. We report a rare case of an infant with HLHS [Severe Aortic Stenosis (AS), Mitral Stenosis (MS) and small Left Ventricle (LV)], who developed aortic regurgitation and presumed coronary steal late after the Sano Modification of the Norwood Procedure. Coronary steal developed secondary to progressive aortic and mitral regurgitation and resulted in poor right ventricular function and severe tricuspid regurgitation. We describe a novel interventional approach for obliteration of the LV cavity by using hydrogel coils. LV obliteration eliminated the presumed steal and resulted in improvement in ventricular function, tricuspid regurgitation and clinical course.

Keywords: HLHS; coil occlusion; coronary steal.

Publication types

  • Case Reports

MeSH terms

  • Angiography
  • Aortic Valve Insufficiency / diagnosis
  • Aortic Valve Insufficiency / etiology
  • Aortic Valve Insufficiency / surgery*
  • Cardiac Catheterization / methods*
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / surgery*
  • Humans
  • Hypoplastic Left Heart Syndrome / diagnosis
  • Hypoplastic Left Heart Syndrome / surgery*
  • Infant
  • Male
  • Norwood Procedures / adverse effects*
  • Postoperative Complications*
  • Reoperation
  • Septal Occluder Device*