Cor Vasa 2020, 62(6):574-577 | DOI: 10.33678/cor.2020.078
(Stenting of arterial duct and right ventricular outflow tract as alternative to surgical shunts in children with cyanotic congenital heart defects)
- Dětské kardiocentrum 2. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice v Motole, Praha
Aim: Analysis of right ventricular outflow tract and arterial duct stenting used as alternative to surgical systemic to pulmonary shunts in newborns and infants with congenital heart defects and critically low pulmonary blood flow.
Methods: From 7/2012 to 12/2019 15 consecutive patients aged 2-102 (median 14, IQR 8-27) days having a median weight of 3.1 (IQR 2.6-3.7) kg were treated. In 11 patients with tetralogy of Fallot or Fallot type double-outlet right ventricle stents were implanted into the right ventricular outflow tract. In the remaining four patients (three patients with critical pulmonary valve stenosis and insufficient right ventricular capacity and one patient with extreme form of Ebstein's anomaly of the tricuspid valve) the arterial duct was stented. Mainly coronary stents were used.
Results: There was no mortality. Eight patients survived until corrective heart surgery without need of another procedure. Three patients (20%) underwent additional palliative procedure. Median time from right ventricular outflow tract stenting to subsequent surgical procedure was 205 (IQR 125-316) days. All four patients with stented arterial ducts were followed-up for a median of 2.8 (IQR 1.5-4.1) years and required so far no additional procedure. There was one complication (6.7%) - minor injury of AV valve.
Conclusion: Stenting of the right ventricular outflow tract and arterial duct are safe and effective alternatives to surgical shunt procedures in newborns and infants with suitable types of cyanotic congenital heart defects.
Keywords: Arterial duct, Congenital heart defect, Right ventricular outflow tract, Stent
Received: July 1, 2020; Revised: July 1, 2020; Accepted: September 1, 2020; Published: December 11, 2020 Show citation
| ACS | AIP | APA | ASA | Harvard | Chicago | Chicago Notes | IEEE | ISO690 | MLA | NLM | Turabian | Vancouver |
References
- Taussig HB, Blalock A. The tetralogy of Fallot; diagnosis and indications for operation; the surgical treatment of the tetralogy of Fallot. Surgery 1947;21:145.
Go to original source... 
Go to PubMed... - Petrucci O, O'Brien SM, Jacobs ML, et al. Risk factors for mortality and morbidity after the neonatal Blalock-Taussig shunt procedure. Ann Thorac Surg 2011;92:642-651; discussion 651-652. Go to original source... Go to PubMed...
- Gibbs JL, Rothman MT, Rees MR, et al. Stenting of the arterial duct: a new approach to palliation for pulmonary atresia. Br Heart J 1992;67:240-245. Go to original source... Go to PubMed...
- Gibbs JL, Uzun O, Blackburn ME, et al. Right ventricular outflow stent implantation: an alternative to palliative surgical relief of infundibular pulmonary stenosis. Heart 1997;77:176-179. Go to original source... Go to PubMed...
- Quandt D, Ramchandani B, Penford G, et al. Right ventricular outflow tract stent versus BT shunt palliation in Tetralogy of Fallot. Heart 2017;103:1985-1991. Go to original source... Go to PubMed...
- Bentham JR, Zava NK, Harrison WJ, et al. Duct Stenting Versus Modified Blalock-Taussig Shunt in Neonates With Duct-Dependent Pulmonary Blood Flow: Associations With Clinical Outcomes in a Multicenter National Study. Circulation 2018;137:581-588. Go to original source... Go to PubMed...
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.