Abstract
BACKGROUND: The balance of pulmonary and systemic blood flow is the fundamental paradigm that influences decision-making in cardiovascular shunt physiology. CASE SUMMARY: This case discusses a term neonate with a prenatal diagnosis of 22q11.2 deletion syndrome and tetralogy of Fallot with near pulmonary atresia, a confluent but severely hypoplastic main pulmonary artery and right pulmonary artery, an isolated left pulmonary artery from the aorta, and major aortopulmonary collateral arteries. Before surgical intervention, a right ventricular outflow tract stent was placed along with a modified microvascular plug (mMVP; Medtronic) to restrict flow in the left pulmonary artery. DISCUSSION: Recently, there have been case reports using an mMVP as a pulmonary flow restrictor. This innovative technique has shown promise in modulating pulmonary blood flow for patients awaiting surgical interventions or for whom surgery presents significant risks. TAKE-HOME MESSAGE: In patients with excess pulmonary blood flow, use of an mMVP to restrict flow can be a viable bridge to surgical intervention.