Journal of JCIC

The case involved an 11-month-old female infant with Williams syndrome, supravalvular aortic stenosis, and peripheral pulmonary artery stenosis. She underwent supravalvular aortic enlargement, coronary ostial plasty, and pulmonary arterioplasty. Due to elevated right ventricular pressure, the surgery was completed under extracorporeal membrane oxygenation. Balloon pulmonary angioplasty (BPA) was performed on the 8th day postoperatively for both pulmonary arteries. BPA was performed on five lesions in the left and right pulmonary artery, using a 0.014-inch Aguru™ guidewire and a 3 mm balloon. As the sixth procedure, BPA was performed for diffuse stenotic lesion of the right upper pulmonary artery with a 1 mm diameter using the same guidewire and balloon. After BPA, the guidewire became irretrievable. Attempts to retrieve the guidewire with a pigtail catheter and a snare catheter were unsuccessful. Surgical removal was attempted, but removal was not possible completely. Guidewire entrapment can occur in cases of diffuse stenotic lesions in pulmonary arteries. We need to consider the risk of fracture in guidewires with metal fatigue.