Customized Pulmonary Artery Stent for Management of Complex Coronary Artery Fistula.

BACKGROUND

Coronary artery fistulas (CAFs) are rare anomalies that can cause ischemia, arrhythmias, and sudden cardiac death. Conventional closure techniques often fail in anatomically complex cases.

SUMMARY: We present the first-in-human use of a customized, partially covered G-Armor pulmonary artery (PA) stent to manage a left main-to-right pulmonary artery fistula in a patient with Shone complex. The intervention was planned using a three-dimensionally printed model, allowing precise stent customization to avoid obstruction of key pulmonary branches.

DISCUSSION: This case shows the feasibility of using customized endovascular devices to address complex CAFs in high-risk patients. The intervention improved antegrade coronary perfusion and clinical outcomes.

NOVELTY: To the best of our knowledge, this is the first reported case of a customized partially covered PA stent for CAF management.

TAKE-HOME MESSAGE: In anatomically complex and high-risk CAFs, customized stenting offers a viable solution when conventional therapies fail.