Objective:

To report a case of urgent RVOT stenting in a high-risk adult with congenital heart disease who faced thrombosis and bleeding complications.

Approach:

• Case Presentation: A 30-year-old woman with double-outlet right ventricle, subaortic ventricular septal defect, and severe infundibular pulmonary stenosis underwent urgent RVOT stenting after experiencing cardiac arrest due to profound hypoxia, complicated by polycythemia, upper extremity deep vein thrombosis, and active gastrointestinal bleeding.

Key Findings:

• Post-procedure, the patient's oxygen saturation improved to 92% from a baseline of 78%.
• Gastrointestinal bleeding ceased and deep vein thrombosis regressed without anticoagulation.
• The patient completed phase II cardiac rehabilitation with improved functional capacity.

Interpretation:

Urgent RVOT stenting may restore pulmonary blood flow and stabilize thrombotic and bleeding complications in high-risk ACHD patients.

Limitations:

• The case is a single patient report, limiting generalizability.
• Long-term outcomes and potential complications of RVOT stenting in similar patients are not discussed.

Conclusion:

RVOT stenting may be a therapeutic option in high-risk ACHD patients.