Ductal stenting to improve pulmonary blood flow in pulmonary atresia with intact ventricular septum and critical pulmonary stenosis after balloon valvuloplasty
| Autor: | Zakhia Saliba, Najib Hanna, Ghassan Chehab, Ramy Charbel, Linda Daou, Raymond N Haddad |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Balloon Valvuloplasty
Heart Defects Congenital Male Pulmonary Circulation medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology Balloon Stent patency 03 medical and health sciences 0302 clinical medicine medicine Humans Pulmonary blood flow 030212 general & internal medicine Interventricular septum Lebanon Retrospective Studies business.industry Angiography Infant Newborn Stent General Medicine medicine.disease Balloon valvuloplasty Surgery Pulmonary Valve Stenosis Stenosis Treatment Outcome medicine.anatomical_structure Pulmonary Atresia Pediatrics Perinatology and Child Health Ventricular Function Right Female Stents Cardiology and Cardiovascular Medicine Pulmonary atresia business |
| Zdroj: | Cardiology in the Young. 29:492-498 |
| ISSN: | 1467-1107 1047-9511 |
| DOI: | 10.1017/s1047951119000118 |
| Popis: | Objective:To assess the feasibility, safety, and efficiency of ductal stenting in pulmonary atresia with intact ventricular septum or critical pulmonary stenosis after balloon pulmonary valvuloplasty.Background:Ductal stenting in pulmonary atresia with intact ventricular septum is a re-emerging and promising technique. There is little data available on its outcomes after establishing prograde pulmonary blood flow.Methods:We retrospectively reviewed all neonates with pulmonary atresia with intact ventricular septum or critical pulmonary stenosis who underwent ductal stenting after balloon valvuloplasty. Ductal stenting was performed either in the same setting (group A) or a few days later after balloon valvuloplasty (group B). We compared the two groups.Results:Eighteen coronary stents were transvenously delivered and successfully deployed in 18 newborns. There was no procedure-related mortality. The median hospital stay post-intervention was 6 days with a mean discharge oxygen saturation of 94%. Group A had a shorter overall hospital stay with a shorter overall time of irradiation but with a longer overall procedural time. On a follow-up of 18 months, no re-intervention for stent failure or overflow was undertaken. The median stent patency based on echocardiography was 12 months.Conclusion:Stenting the arterial duct in pulmonary atresia with intact ventricular septum or critical pulmonary stenosis is a feasible, safe, and efficient technique. It avoids surgery or long hospital stay with prostaglandin infusion. The minimal 6 months stent longevity provides a period of time long enough to decide whether the right ventricular diastolic function is normalised or Glenn surgery is still needed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|