Urgent right ventricular outflow tract stenting in a dual risks of thrombosis and bleeding in uncorrected adult with cyanotic congenital heart disease: a case report.

BACKGROUND

Uncorrected adults congenital heart disease (ACHD) may present with profound hypoxia and dual risks of thrombosis and bleeding, posing major challenges for definitive surgical repair. In such settings, right ventricular outflow tract (RVOT) stenting may provide a life-saving palliative option.

CASE PRESENTATION: We report a 30-year-old woman with double-outlet right ventricle, subaortic ventricular septal defect, and severe infundibular pulmonary stenosis who suffered cardiac arrest due to profound hypoxia. Her clinical profile was complicated by polycythemia, upper extremity deep vein thrombosis, and active gastrointestinal bleeding. In light of prohibitive surgical risk, urgent RVOT stenting was undertaken, requiring multiple technical adaptations due to severe obstruction. Post-procedure, oxygen saturation improved to 92%, gastrointestinal bleeding ceased, and deep vein thrombosis regressed without anticoagulation. She subsequently completed phase II cardiac rehabilitation with improved functional capacity.

CONCLUSION

Urgent RVOT stenting can serve as a feasible therapeutic option in high-risk ACHD patients, effectively restoring pulmonary blood flow while simultaneously stabilizing thrombotic and bleeding complications.