Stenting of the inter-atrial septum in infants and small children: Indications, techniques and outcomes

Autor: Gur Mainzer, Sebastian Góreczny, Jadwiga Moll, Gareth J. Morgan, Paweł Dryżek, Shakeel A. Qureshi, Eric Rosenthal, Thomas Krasemann, Tomasz Moszura
Přispěvatelé: Pediatrics
Rok vydání: 2018
Předmět:
Heart Defects
Congenital
Male
Cardiac Catheterization
medicine.medical_specialty
Adolescent
medicine.medical_treatment
030204 cardiovascular system & hematology
Radiography
Interventional
03 medical and health sciences
0302 clinical medicine
Risk Factors
London
Humans
Medicine
Radiology
Nuclear Medicine and imaging
In patient
cardiovascular diseases
030212 general & internal medicine
Child
Adverse effect
Ultrasonography
Interventional
Retrospective Studies
Atrial Septum
business.industry
Age Factors
Infant
Newborn
Small children
Infant
Stent
General Medicine
medicine.disease
Pulmonary hypertension
Atrial septum
Echocardiography
Doppler
Color
Surgery
Treatment Outcome
Child
Preschool
Balloon dilation
Flow restriction
Female
Stents
Poland
Cardiology and Cardiovascular Medicine
business
Echocardiography
Transesophageal
Zdroj: Catheterization and Cardiovascular Interventions, 91(7), 1294-1300. Wiley-Liss Inc.
ISSN: 1522-726X
1522-1946
DOI: 10.1002/ccd.27462
Popis: Objectives: To evaluate the procedural success and outcome of inter-atrial stenting. Background: Inter-atrial stenting has been shown to be an effective way to maintain inter-atrial blood flow, however it is considered a high risk procedure, usually performed urgently in patients with significant hemodynamic compromise. Methods: Between September 2004 and August 2016, inter-atrial stenting was attempted in 29 children. Procedural, clinical, and follow-up data were collected retrospectively. Results: The procedures were completed successfully in 27 patients. Twenty-five procedures were undertaken percutaneously, with the remaining four being performed as hybrid procedures. The patients were considered as high risk for adverse events (82% scored as CRISP 4 and 5) with four deaths during the first 24 hr (14%). Procedural complications occurred in eight patients (28%) with related death in three patients (10%). One further patient died after an uncomplicated technically successful stent implantation performed as a salvage procedure. Procedural complications (71% vs. 14%) and mortality (43% vs. 5%) were higher in those, who weighed 3 kg or less (P < 0.05). Patency of the stents was maintained until planned staged surgery in 22 patients at a mean of 302 days. Three patients underwent further balloon dilation for flow restriction at 58–201 days. In two un-operated patients the stents remained patent at follow-up. One patient with severe pulmonary hypertension died with a patent stent. Conclusions: Inter-atrial stenting produces reliable patency with a very good success rate. Morbidity and mortality were related to low weight at the time of the procedure.
Databáze: OpenAIRE
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