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Case Reports
. 2014 Jun;24(3):327-30.

Minimally invasive transthoracic device closure of an acquired sinus of valsalva-right ventricle fistula in a pediatric patient

Lei Gao  1 , Qin Wu  1 , Xinhua Xu  1 , Tianli Zhao  1 , Yifeng Yang  1
Affiliations
Case Reports

Minimally invasive transthoracic device closure of an acquired sinus of valsalva-right ventricle fistula in a pediatric patient

Lei Gao et al. Iran J Pediatr. 2014 Jun.

Abstract

Background: Sinus of Valsalva-right ventricle fistula is a recognized but very rare complication after surgical repair of subaortic ventricular septal defect. Surgical repair with cardiopulmonary bypass and percutaneous transcatheter closure guided by x-ray has been the traditional treatment for fistula of sinus of Valsalva.

Case presentation: Recently, we have used a novel approach, that avoids the need for either secondary open surgical repair or radiation exposure; that is, minimally invasive transthoracic device closure guided by transesophageal echocardiography to occlude an acquired sinus of Valsalva-right ventricle fistula in a 4-year-old patient.

Conclusion: To our knowledge, there have been no prior cases reported of this technique applied to close an acquired sinus of Valsalva-right ventricle fistula. This report aims to provide a detailed description of the procedure.

Keywords: Fistula of Sinus of Valsalva; Minimally invasive; Device Closure; Transesophageal Echocardiography.

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Figures

Fig. 1
Fig. 1
A: Transthoracic echocardiography showing the fistula of RSOV to RV. B: Color Doppler showing a continuous shunt from RSOV to RV with high velocity (4.5 m/s). C: Transthoracic echocardiography revealing satisfactory position of the occluder, with neither residual shunt nor aortic regurgitation
Fig. 2
Fig. 2
A : Transesophageal echocardiography showing fistula of RSOV opening into RVOT. B: TEE showing the guide wire (arrow) passed through the fistula into RSOV. C: Full deployment of the occluder in the fistula after release, with no residual shunt or aortic regurgitation.
Fig. 3
Fig. 3
Chest X-ray showing the position of the occluder after occlusion of the sinus of Valsalva-right ventricle fistula (arrow)
See this image and copyright information in PMC

References

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