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Iatrogenic aortopulmonary fistula after balloon dilation of right pulmonary artery stent following truncus arteriousus type 1 repair.

Sultan A. Alharthi, Atif Alsahari, Falih A. AlQahtani, Jassim M. Abdulhamed

Iatrogenic aortopulmonary (AP) fistula is an unusual complication after balloon pulmonary artery (PA) angioplasty or branch pulmonary arteries (PAs) stent dilation. The majority of the cases were reported after transcatheter interventions on the PAs or right ventricular outflow tract (RVOT), in patients with transposition of great arteries (TGA) who underwent PA angioplasty following arterial switch operation (ASO) or after transcutaneous pulmonary valve replacement in patients who had undergone a Ross procedure. We present a case of iatrogenic AP fistula in a 4-year-old patient with a history of repaired truncus arteriosus type 1 followed by bilateral PAs stent placement and balloon dilation,17 months later redilation of the right pulmonary artery (RPA) stent resulted in a AP fistula with significant left to right shunt which was successfully closed with a covered stent. This case demonstrates a previously unreported complication of transcatheter RPA stent reintervention after truncus arteriosus repair.