Sutureless rescue of a severely hypoplastic pulmonary artery

The management of severely hypoplastic pulmonary arteries in the adolescent or adult with congenital heart disease is challenging. A patient with pulmonary atresia and ventricular septal defect (PA-VSD) presented with severe cyanosis due to a kinked and thrombosed right ventricle to pulmonary artery conduit. Retrograde wedge angiography showed a patent right and a diminutive left pulmonary artery deep in the lung hilus. Treatment options were limited and therefore a different strategy had to be considered to rescue the lung segments. This case report describes the novel use of a covered stent to successfully obtain a sutureless connection between a vascular graft and a diminutive pulmonary artery during a hybrid procedure.