One-stage relief of bilateral outflow tract obstruction and left main coronary ostial stenosis in an infant with Williams syndrome: the technique

A 3-month-old, 5.2-kg infant with Williams syndrome presented with failure to thrive and a systolic murmur. He was taken to the cardiac catheterization laboratory for a planned pulmonary valvotomy based on findings of severe pulmonary stenosis on the transthoracic echocardiogram. However, he suffered cardiac arrest and had to be resuscitated; the procedure was aborted. Cardiac catheterization revealed suprasystemic right ventricular pressure and severe bilateral branch pulmonary artery stenosis with bilateral branch hypoplasia. The decision was made to proceed with surgical relief of the obstruction.