Endovascular approach for revascularization of an occluded aortopulmonary shunt

• A 33-year-old man referred with complex congenital heart disease including pulmonary atresia and anomalous single trunk coronary artery from ascending aorta. He had previously undergone palliative surgery to place a central shunt between ascending aorta and main pulmonary artery.
• After 1 year, he presented with exertional dyspnea FC III, fatigue, and exacerbation of cyanosis, with a reduction in oxygen saturation to 65%. Echocardiography and CT angiography of aorta demonstrated occlusion of central shunt.
• Due to a very high operative risk, heart team decision preferred PTA of occluded central aortopulmonary shunt over re-do surgery.