Application of a homemade stent graft to the pulmonary arteries in a patient with total cavopulmonary connection.

Despite increasing popularity in the use of stent grafts to treat aortic diseases, stent grafts are used for pulmonary arterial lesions less frequently. In particular, to our knowledge no report has described stent graft implantation into the pulmonary arteries in patients with total cavopulmonary connection (Fontan operation). This rarity might be related to the inability of commercially available devices to conform to the complex vascular geometry in these patients. We report the successful application of a homemade stent graft, which had been designed according to a preliminary angiographic assessment, to simultaneously treat left pulmonary artery stenosis and residual shunt, without reoperative sternotomy, long after Fontan completion.