A 26-day-old male infant with acute renal failure and heart failure of unknown cause was treated in the Intensive Care Unit (ICU) with mechanical ventilation, diuretics and vasoactive drugs.
Among the requested tests, a contrast-enhanced Pulmonary CAT scan showed a large vessel originating from the upper abdominal aorta and heading to the base of the left lung, suggesting the diagnosis of PS.
The patient was evaluated by a cardiologist and congenital heart disease was ruled out.
Due to the critical condition of the patient, the hemodynamic study was planned and eventual embolization of the anomalous vessel.
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A diaphragm study was performed under general anesthesia, using the right femoral artery with 4 French rendering. A chest x-ray was performed with a 4 French Pigil catheter showing stability of the left abdominal aorta. After this, a four-mm Tail catheter was introduced under total occlusion.
The procedure was uneventful.
The patient was controlled with chest X-ray and echocardiogram prior to discharge, showing in situ device in the chest plaque, free lung fields and cardiomegaly in frank regression and improvement of cardiac function.
The day after the procedure, the mechanical ventilator was removed and, 72 hours later, the vasoactive drugs treatment was suspended, progressing satisfactorily and being referred to the hospital of origin.
The patient was controlled at week, month, 6 months, year and 2 years post-intervention. All controls were asymptomatic and in good condition.
A control CT scan was also performed in two patients, which showed regression of the lesion.
