Ductus Arteriosus Patency With Stenting in Critical Pulmonary Stenosis and Pulmonary Atresia With Intact Interventricular Septum

Mortera, Carlos; Rissech, Miquel; Bartrons, Joaquim; Carretero, Juan; Prada, Fredy

doi:10.1016/s1885-5857(06)60736-6

Cited by 7 publications

(5 citation statements)

References 14 publications

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“…1 Moreover, since it has been estimated that most of the infants suffering from pulmonary atresia with intact ventricular septum can be managed by cardiac catheterisation, ductal stenting prevails as a logical non-surgical alternative to maintain ductal patency. 7,8 Notwithstanding its rising popularity, this attractive technique is a challenge for the interventionist as much as for the delicacy of the manoeuvers performed, as for the choice of advanced equipment and particularly the timing of the procedure. Ductal stenting has been successfully used in diseases with duct-dependent pulmonary blood flow.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6] Although ductal stenting has been studied in a small series in the setting of mixed patients with ductal-dependent pulmonary circulation, rare studies reviewed ductal stenting strategy in a selected group of pulmonary atresia with intact ventricular septum. [7][8][9] In this study, we highlight the efficiency of this technique and analyse our short-and medium-term results of ductal stenting in pulmonary atresia with intact ventricular septum (or critical pulmonary stenosis) with a right ventricular anatomy suitable for biventricular repair.…”

Section: Introductionmentioning

confidence: 99%

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Ductal stenting to improve pulmonary blood flow in pulmonary atresia with intact ventricular septum and critical pulmonary stenosis after balloon valvuloplasty

et al. 2019

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ductal stenting to improve pulmonary blood flow in pulmonary atresia with intact ventricular septum and critical pulmonary stenosis after balloon valvuloplasty

et al. 2019

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“…Estos procedimientos se indican cuando la obstrucción en la rama pulmonar causa hipoperfusión del pulmón afecto, elevación de la presión del ventrículo derecho o insuficiencia del mismo. Stent ductal: En la atresia pulmonar y estenosis pulmonar crítica, una vez que se ha resuelto por cateterismo el problema más importante, es decir haber logrado la apertura de la válvula pulmonar, se observa que el ventrículo derecho no es capaz de mantener el gasto pulmonar, por lo que se optaba por crear una fístula de Blalock Taussig; últimamente implantamos un stent en el ductus (8) . La técnica requiere un acceso arterial y la utilización de un stent de 4 mm de diámetro (Figura 8); la longitud del stent dependerá de la longitud del ductus.…”

Section: Angioplastía De Ramas Pulmonaresunclassified

Cateterismo cardiaco terapéutico en niños

Prada Martínez

2007

Rev Peru Pediatr

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La cateterización cardiaca pediátrica ha cambiado en los últimos años, surgió como una herramienta de diagnóstico, pero gradualmente se ha convertido en una opción útil para el tratamiento de muchas anomalías congénitas cardiacas. Hay lesiones o estructuras cardiacas que son restrictivas o estenóticas y necesitan para ser tratadas procedimientos como la angioplastía, valvuloplastía o septostomía de Rashkind. Por otro lado, hay lesiones que producen cortocircuitos intracardiaco o extracardiaco y que deben ser cerrados con dispositivos que se liberan de forma percutánea. Existen muchos tipos de dispositivos, pero los de Amplatzer necesitan especial mención porque son útiles para cerrar una amplia gama de defectos como DAP, CIA, CIV y conexiones vasculares anómalas. Con el perfeccionamiento de la tecnología ahora es posible tratar aun a los recién nacidos con estas técnicas modernas.

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“…The severity of the RV hypoplasia determines whether a biventricular or univentricular approach is needed. The surgical placement of a systemic to pulmonary shunt, such as a Blalock–Taussig shunt, is an invasive procedure that has risks of thoracotomy and cardiopulmonary bypass, distortion of pulmonary arteries, and phrenic nerve palsy . Although surgical techniques and intensive care have improved since the last decade, mortality and morbidity due to surgical shunts are still high in neonates (4,5).…”

mentioning

confidence: 99%

“…Developments in transcatheter techniques offer a different treatment option for this complex pathology. Percutaneous stenting of patent ductus arteriosus (PDA) and radiofrequency (RF)‐assisted atretic valve perforation are promising procedures for surgery in the neonatal period (3,4). The aim of this study was to investigate the early‐ and mid‐term results for the transcatheter approach in neonates with PAIVS.…”

mentioning

confidence: 99%

Transcatheter Management of Neonates With Pulmonary Atresia With Intact Ventricular Septum: A Single Center Experience From Turkey

et al. 2013

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Pulmonary atresia with intact ventricular septum (PAIVS) is characterized by a broad spectrum of heterogeneous morphologies. Perforation of the atretic valve, balloon dilatation, and stenting of the patent ductus arteriosus are the percutaneous techniques that are used with increasing frequency in our clinic as well. They have some advantages over surgery, including short hospital stay and short intensive care unit stay. The main goal of the primary interventional approach is to avoid surgery. However, a group of patients with PAIVS still need surgery due to poor right ventricular growth. Therefore, the final achievement of the initial percutaneous treatment strategies is still debatable. In this article, we present the early- and mid-term results of the percutaneous approach utilized at our clinic in order to investigate the final effects of interventional therapy according to initial morphology. Between May 2010 and May 2012, 15 neonates diagnosed with PAIVS underwent transcatheter intervention. Detailed echocardiographic examination focused on right ventricle size, and tricuspid valve morphology and coronary sinusoids were performed in all the patients before the intervention. Nine of the patients were boys and six were girls. The mean age was 11.40 ± 12.87 days and mean weight was 3.34 ± 0.46 kg. Only one procedure-related mortality occurred. The mean follow-up period was 10.05 ± 3.42 months (1-26 months). The mean duration of intensive care was 7.19 ± 5.14 days. The mean follow-up time was 10.05 ± 3.42 months. After this period, survival rate was 66% (10/15). Two of the patients achieved biventricular physiology after pulmonary valve perforation. Two patients still have univentricular physiology. Six patients have been followed as a one and half ventricle repair candidate. Five out of 15 patients had stent patency during 6 months of follow-up, while restenosis developed in one patient (1/5, 20%), who had undergone the Glenn operation at 5 months of age. Transcatheter management for PAIVS is a feasible, safe, and effective primary palliative treatment in newborns. Shunt surgery may be considered in cases where cyanosis occurs despite transcatheter intervention. Right ventricular size determines the type of intervention. The early outcomes can be comparable with surgical palliation. However, a group of PAIVS, particularly with severe right ventricular hypoplasia, needs surgery even after a successful primary percutaneous intervention.

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Ductus Arteriosus Patency With Stenting in Critical Pulmonary Stenosis and Pulmonary Atresia With Intact Interventricular Septum

Cited by 7 publications

References 14 publications

Ductal stenting to improve pulmonary blood flow in pulmonary atresia with intact ventricular septum and critical pulmonary stenosis after balloon valvuloplasty

Ductal stenting to improve pulmonary blood flow in pulmonary atresia with intact ventricular septum and critical pulmonary stenosis after balloon valvuloplasty

Cateterismo cardiaco terapéutico en niños

Transcatheter Management of Neonates With Pulmonary Atresia With Intact Ventricular Septum: A Single Center Experience From Turkey

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