Balloon dilatation of a stenotic Waterston shunt with long-term follow-up

After its successful introduction in 1982 for the treatment of congenital heart lesions, percutaneous balloon dilatation has been applied to many stenotic lesions found in preoperative and postoperative congenital heart disease.^1,2 There have been rare reports of this technique's application to surgical aortopulmonary connection with varying results. Fischer et al³ described successful dilatation of a Blalock-Taussig anastomosis, and Gibbs et al⁴ described balloon dilatation of a Waterston anastomosis after which pulmonary edema developed and the patient died 12 hours after the procedure. A recent case report of long-term follow-up after initially successful balloon dilatation of a variant of a Blalock-Taussig shunt documented late remodeling at the angioplasty site and distal pulmonary hypertension.⁵ We describe the successful long-term outcome after balloon dilatation of a stenotic Waterston anastomosis.