Emergency Stenting of the Right Ventricular Outflow Tract in an Adult with Cyanotic Congenital Heart Disease Facing Thrombosis and Bleeding Risks: A Case Study

Overview

This case study presents a 30-year-old woman with complex congenital heart disease who underwent emergency right ventricular outflow tract (RVOT) stenting due to severe hypoxia and associated risks of thrombosis and bleeding. Post-procedure, her oxygen saturation improved to 92%, and gastrointestinal bleeding ceased.

Background

Management of congenital heart diseases has improved significantly, with many patients surviving into adulthood. However, uncorrected adult congenital heart disease can lead to severe complications, including chronic hypoxia and dual risks of thrombosis and bleeding. RVOT stenting is a palliative option for patients with severe pulmonary underperfusion, particularly when surgical repair is deemed too risky.

Data Highlights

No numerical data or trial data available in the source material.

Key Findings

• A 30-year-old woman with double-outlet right ventricle and severe pulmonary stenosis underwent emergency RVOT stenting.
• She presented with profound hypoxia, polycythemia, and upper extremity deep vein thrombosis.
• Post-stenting, her oxygen saturation improved to 92%, and gastrointestinal bleeding ceased.
• Deep vein thrombosis regressed without the need for anticoagulation.

Clinical Implications

Emergency RVOT stenting can restore pulmonary blood flow in patients with complex congenital heart disease facing significant surgical risks.

Conclusion

The case illustrates that urgent RVOT stenting can be a therapeutic option for high-risk patients with cyanotic congenital heart disease.

Related Resources & Content

1. American College of Cardiology, 2025 -- New ACC/AHA Guideline Addresses Management of Congenital Heart Disease in Adults
2. PMC, 2023 -- Right ventricular outflow tract stenting for obstructive lesions in adult congenital heart disease
3. Pediatric Cardiology — Creation of Transcatheter Ventricular Septal Defects for Restrictive VSD in Cases of Double-Outlet Right Ventricle
4. Pediatric Cardiology — Proceedings of the PICS-AICS Virtual Symposium Held from September 10 to 12, 2020
5. Pediatric Cardiology — Interventional Treatment for Tetralogy of Fallot Expected to Advance Within the Next Twenty Years
6. Pediatric Cardiology — Innovative Applications of the SwiftNinja Steerable Microcatheter in Pediatric Cardiac Procedures
7. New ACC/AHA Guideline Addresses Management of Congenital Heart Disease in Adults - American College of Cardiology
8. Right ventricular outflow tract stenting for obstructive lesions in adult congenital heart disease - PMC
9. Thromboprophylaxis and adult congenital heart disease: The latest on indications, risk scoring and therapy - ScienceDirect