BRANCH PULMONARY ARTERY STENOSIS

1. MURTAZA KAMAL
28/12/2018
Murtaza.vmmc@gmail.com
1
CATH MEET
cath meet 27/12/20018

2. PATIENT’S DETAILS
B/o XYZ: 13M/M
Diagnosed with: CRS (TRIAD)
OPERATED: JAN 18 (PULMONARY OUTFLOW TRACT
AUGMENTATION WITH TAP AND PULMONARY
VALVOTOMY WITH PDA LIGATION), MARCH 18
FOLLOW UP
Stable vitals, Midline scar, Early diastolic murmur at ULSB
Grade-3
cath meet 28/12/200182

3. ECG
3 cath meet 27/12/20018

4. ECHO
4
ECHO DIAGNOSIS: S/P PULMONARY OUTFLOW
TRACT AUGMENTATION WITH TAP AND
PULMONARY VALVOTOMY WITH PDA LIGATION IN
JAN 2018, NO RVOTO/ FREE PR, SEVERE LPA STENOSIS,
TINY MID MUSCULAR VSD WITH LEFT TO RIGHT
SHUNT, GOOD BIVENTRICULAR FUNCTION

5. CARDIAC CATH
INDICATION :- Assessment of PA anatomy
Sheath: 4F LFA/ 6F RFV
Route: Right and Left Femoral
Heparin: 800 IU
cath meet 27/12/200185

6. LPA = 24/6/13
6 cath meet 27/12/20018

7. MPA= 49/10/20
7 cath meet 27/12/20018

8. LPA TO MPA pullback gradiant=25mm
Hg
8 cath meet 27/12/20018

9. RPA lower branch = 23/8/12
9 cath meet 27/12/20018

10. RPA lower branch TO MPA pullback
10 cath meet 27/12/20018

11. Gradiant = 26mm Hg
11 cath meet 27/12/20018

12. RPA upper branch = 47/3/17
12 cath meet 27/12/20018

13. Rt upper branch to MPA Pullback=
3mm Hg
13 cath meet 27/12/20018

14. MPA TO RV pullback= 18mm Hg
14 cath meet 27/12/20018

15. RV 67/O/10
15 cath meet 27/12/20018

16. LV =120/25/62
16 cath meet 27/12/20018

17. AORTA=128/56/89
17 cath meet 27/12/20018

18. AORTA (200 scale)
18 cath meet 27/12/20018

19. FA =140/60/90
19 cath meet 27/12/20018

20. 20
CHAMBER PRESSURE (IN mm
Hg)
Aorta 128/56/89
MPA 49/10/20
RV 67/10
LV 120/25/62
LPA 24/6/13
RPA Lower branch 23/8/12
RPA upper branch 47/3/17
cath meet 27/12/20018

21. RV ANGIO - AP cranial 40
21 cath meet 27/12/20018

22. PA ANGIO – RAO 30
22 cath meet 27/12/20018

23. PA ANGIO- LAO 10 caudal 30
23 cath meet 27/12/20018

24. PA ANGIO- LATERAL
24 cath meet 27/12/20018

25. LV ANGIO –LAO40 cranial40
25 cath meet 27/12/20018

26. 26
LPA ostium: 2.1 mm (Z Score: -6.47)
LPA distal : 5.2 mm (Z Score: -1.06)
RPA proximal: 4.8mm (Z Score:-2.27)
RPA Upper branch proximal : 5.9 mm (Z Score: -1.01)
RPA Lower branch ostium: 1.4 mm
RPA Lower branch distal : 2.7 mm
cath meet 27/12/20018

27. PLAN OF ACTION
27
Lung perfusion scan followed by LPA Stenting and balloon
dilatation of lower branch of RPA
cath meet 27/12/20018

28. THANK YOU
cath meet 27/12/2001828