Concentric placement of stents to relieve an obstructed anomalous pulmonary venous connection

Intravascular or intracardiac stenoses occur in many forms of congenital heart disease (CHD). Therefore, the implantation of stents has become an accepted interventional procedure for stenotic lesions in pediatric cardiology. Furthermore, stents are know to be used to exclude vessel aneurysm or to ensure patency of existing or newly created intracardiac communications. With the further refinement of the first generation of devices, a variety of “modern” stents with different design characteristics have evolved. Despite the tremendous technical improvement over the last 20 years, the “ideal stent” has not yet been developed. Therefore, the pediatric interventionalist has to decide which stent is suitable for each lesion. On this basis, currently available stents are discussed in regard to their advantages and disadvantages for common application in CHD. New concepts and designs developed to overcome some of the existing problems, like the failure of adaptation to somatic growth, are presented. Thus, in the future, biodegradable or growth stents might replace the currently used generation of stents. This might truly lead to widening indications for the use of stents in the treatment of CHD.

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“…Thus, stent therapy usually is of a palliative nature[52132138139] and may serve as a bridge to lung transplantation. [140]…”

Section: Stenting the Aortamentioning

confidence: 99%

The role of stents in the treatment of congenital heart disease: Current status and future perspectives

2009

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“…On physical examination, marked stridor can be auscultated11). Additionally, in serious cases, fully developed pulmonary edema, hypoxemia, cyanosis and growth failure may appear7). Our case had recurrent pulmonary infection, i.e., pneumonia, due to the right heart volume overload condition.…”

Section: Discussionmentioning

confidence: 70%

“…Thus the true incidence of symptomatic patients is expected to be lower. Moreover, at least one anomalous pulmonary venous connection is present in about three-quarters of the patients diagnosed with asplenia syndrome7). Drainage of the right pulmonary vein into either the RA or the SVC is a frequent type2).…”

Section: Discussionmentioning

confidence: 99%

Partial anomalous pulmonary venous connection with intact atrial septum in a child with ventricular septal defect: a case report

Kim

Cho

et al. 2012

Korean J Pediatr

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Partial anomalous pulmonary vein connection (PAPVC) is a rare congenital abnormal cardiac defect involving the pulmonary veins draining into the right atrium (RA) directly or indirectly by venous connection. Ninety percent of PAPVCs are accompanied by atrial septal defect (ASD). To our knowledge, there is no previous report of PAPVC with ventricular septal defect (VSD) without ASD in Korea, and in this paper, we report the first such case. A 2-day-old girl was admitted into the Chonnam National University Hospital for evaluation of a cardiac murmur. An echocardiogram revealed perimembranous VSD without ASD. She underwent patch closure of the VSD at 5 months of age. Although the VSD was completely closed, she had persistent cardiomegaly with right ventricular volume overload, as revealed by echocardiography. Three years later, cardiac catheterization and chest computed tomography revealed a PAPVC, with the right upper pulmonary vein draining into the right SVC. Therefore, correction of the PAPVC was surgically performed at 3 years of age. We conclude that it is important to suspect PAPVC in patients with right ventricular volume overload, but without ASD.

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“…However, recent therapeutic advances have enabled nonoperative methods to be applied in this setting. Coulson et al 11 have used stenting of the anomalous pulmonary vein as a bridge to definitive surgery. Experience with pulmo- nary venous balloon angioplasty and stenting in the adult population has been driven by pulmonary venous stenosis that forms from scarring following radiofrequency ablation for atrial fibrillation.…”

Section: Discussionmentioning

confidence: 99%

Transseptal Stent Treatment of Anastomotic Stricture after Repair of Partial Anomalous Pulmonary Venous Return

Dieter¹,

Nelson²,

Wolff³

et al. 2003

J Endovasc Ther

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Concentric placement of stents to relieve an obstructed anomalous pulmonary venous connection

Cited by 21 publications

References 9 publications

The role of stents in the treatment of congenital heart disease: Current status and future perspectives

The role of stents in the treatment of congenital heart disease: Current status and future perspectives

Partial anomalous pulmonary venous connection with intact atrial septum in a child with ventricular septal defect: a case report

Transseptal Stent Treatment of Anastomotic Stricture after Repair of Partial Anomalous Pulmonary Venous Return

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