Modified microvascular plug as a flow restrictor in a single ventricle patient with MAPCAs

Balancing systemic and pulmonary circulation is paramount to the management of single ventricle heart disease. Insufficient pulmonary blood flow has been managed with a variety of surgical and transcatheter therapeutic options, whereas excessive pulmonary blood flow has been limited to surgical management. Recently, reports have described the use of a modified Microvascular Plug as a pulmonary flow restrictor. We report the use of this technique in a 5-month-old with single ventricle physiology and major aortopulmonary collateral arteries whose clinical course had been complicated by pulmonary over-circulation and necrotizing enterocolitis.