ArticleJACC. Case reports2026
Unconventional Ductal Flow Restriction and Iatrogenic Pseudoaneurysm Plug Closure in Pulmonary Atresia With Intact Septum.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPulmonary atresia with intact ventricular septum (PA/IVS) and right ventricular-dependent coronary circulation pose management challenges requiring creative transcatheter solutions when surgery is unfeasible. CASE SUMMARY: A small-for-gestational-age term neonate with PA/IVS and right ventricular-dependent coronary circulation developed hemodynamic instability after patent ductus arteriosus stenting, requiring deployment of a modified Medtronic Microvascular Plug within the patent ductus arteriosus stent to restrict pulmonary overcirculation. A left external iliac artery pseudoaneurysm was subsequently closed using a 4-mm Konar-A vascular plug.
conclusionsThis case underscores the delicate balance between management of pulmonary over- and undercirculation in neonates with PA/IVS and highlights creative transcatheter strategies used to address these dual hemodynamic dilemmas. Early recognition of at-risk anatomy, and consideration for cardiac transplantation, are essential for survival in these high-risk patients. TAKE-HOME MESSAGE: Unconventional transcatheter strategies may be essential in managing high-risk neonates with congenital heart disease.
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