Endovascular Stent Placement for Right Ventricle to Pulmonary Artery Conduit Stenosis in the Norwood with Sano Modification

Muyskens, Steve; Nicolas, Ramzi; Foerster, Susan; Balzer, David T.

doi:10.1111/j.1747-0803.2008.00181.x

Cited by 14 publications

(8 citation statements)

References 14 publications

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“…Previous case reports have found both transient and permanent complete heart block in patients after stenting of Sano conduits. 11,12 In our study, 10 patients with Sano conduits developed CIHB, 8 with catheter manipulation only. The orientation of the Sano conduit may place patients at higher risk for heart block.…”

Section: Discussionmentioning

confidence: 99%

Incidence of and Risk Factors for Catheterization-Induced Complete Heart Block in the Pediatric Cardiac Catheterization Laboratory

Mah

Porras

Bergersen

et al. 2014

Circ: Arrhythmia and Electrophysiology

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Background-The majority of the literature on catheterization-induced heart block (CIHB) was published >30 years ago.The field of cardiac catheterization has evolved, performing more interventional compared with diagnostic cases. We sought to determine the incidence and risk factors of CIHB. Methods and Results-A catheterization database that records the occurrence of adverse events on all cases was queried for heart block. Additional retrospective data on event outcome were collected on patients who developed CIHB. Multivariable logistic regression modeling was used to identify risk factors of CIHB (odds ratio, 95% confidence interval). In a 6-year period, 6183 cases were performed. The median weight was 15.0 (7.0-47.0) kg, with 29% consisting of infants <1 year. A total of 72% involved complex congenital heart disease. One hundred thirty-five cases were complicated by CIHB (2.2%; 95% confidence interval, 1.9-2.6). Age <1 year (3.0; 2.2-4.3) and case duration ≥2 hours (3.4; 2.0-6.0) were risk factors of CIHB; cardiac anatomy and intervention performed were not. A total of 96% of CIHB recovered within 1 week but 6 patients underwent pacemaker placement (3 L-loop ventricles, 2 intracardiac devices, 1 double inlet-double outlet RV). Of these, 50% recovered atrioventricular nodal conduction within 1 month; 2 patients with L-loop ventricles and 1 patient with a left ventricular-to-right atrial device did not recover. Conclusions-The incidence of CIHB in the pediatric cardiac catheterization laboratory is low at 2.2%. Risk factors include young age and long case duration. The recovery of atrioventricular nodal function after CIHB is high and follows a similar time course to that of postsurgical heart block. (Circ Arrhythm Electrophysiol. 2014;7:127-133.)

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Section: Discussionmentioning

confidence: 99%

Incidence of and Risk Factors for Catheterization-Induced Complete Heart Block in the Pediatric Cardiac Catheterization Laboratory

Mah

Porras

Bergersen

et al. 2014

Circ: Arrhythmia and Electrophysiology

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“…A large number of reports suggest stent placement efficacious for stenotic RV‐PA shunts following stage I palliation . Re‐intervention rates after stent placement are low.…”

Section: Discussionmentioning

confidence: 99%

“…Early stenosis of the RV‐PA shunt following stage I palliation has been a well‐documented phenomenon . The mechanisms of stenosis include kinking or compression of the shunt, distal anastomotic stenosis with or without branch PA stenosis, proximal stenosis related to muscular growth or endothelial growth within the shunt lumen.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of balloon angioplasty for the right ventricle‐pulmonary artery shunt with the modified norwood procedure

Ohno

Ohtsuki

Kataoka

et al. 2012

Cathet Cardio Intervent

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(Word count: 225) Objective: We sought to evaluate the efficacy of balloon angioplasty (BA) for severely desaturated patients due to a stenotic right ventricle (RV) to pulmonary artery (PA) shunt following modified Norwood procedure. Results: BA was performed for stenotic RV-PA shunts following stage I palliation (n=17, 77%), or those placed as an additional blood source (n=5, 23%, 3 patients awaiting biventricular repair, 2 patients following stage II palliation). The location of the BA was at the distal anastomosis in 12 (54.5%), proximal anastomosis in 21 (95.4%) and in the mid-portion of the shunt in 11 (50%) cases. The diameters of these 3 shunt portions were measured from the anterior-posterior and lateral angiographic images, increasing significantly after BA (p<0.0001) in all. Arterial saturation significantly improved after BA in all cases (66.5±4.3% to 79.4±3.4%, p<0.0001). Freedom from reintervention was 100%. All patients underwent subsequent elective planned surgery at an appropriate age Ohno et al. 4 with no mortality.Conclusions: A BA-alone strategy for a stenotic RV-PA shunt was effective for all 3 shunt portions, minimizing shunt-related premature surgical intervention. Ohno et al. 5 BACKGROUND

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“…The patients ranged in age from 10 to 66 months. In the majority of patients (15), the stenosis was localised at the proximal segment of the left pulmonary artery, at the bifurcation at the site of connection of the Sano shunt in nine, proximal left and right pulmonary artery in six, and right pulmonary artery between the pulmonary artery bifurcation and the Glenn shunt in four. Stents were redialated in 16 patients, and in another two patients implantation of the second stent was performed.…”

Section: After Bidirectional Glenn Operationmentioning

confidence: 94%

“…In these patients, we usually recommend an initial balloon angioplasty, and then depending on the outcome may consider implanting a stent in the Sano shunt. 15 The largest number of interventions were in two types of complications of multi-stage treatment: stenosis of the aortic arch/isthmus and stenosis of the pulmonary arteries. These separate anatomical and haemodynamic situations may be interlinked.…”

Section: After Stage I Norwood Operation and Stage Ii Bidirectional Gmentioning

confidence: 99%

A 10-year single-centre experience in percutaneous interventions for multi-stage treatment of hypoplastic left heart syndrome

et al. 2013

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Endovascular Stent Placement for Right Ventricle to Pulmonary Artery Conduit Stenosis in the Norwood with Sano Modification

Abstract: Transcatheter treatment of Sano conduit obstruction can be performed safely and results in immediate improvement in oxygenation, thereby allowing substantial delay of the cavo-pulmonary shunt.

Cited by 14 publications

References 14 publications

Incidence of and Risk Factors for Catheterization-Induced Complete Heart Block in the Pediatric Cardiac Catheterization Laboratory

Incidence of and Risk Factors for Catheterization-Induced Complete Heart Block in the Pediatric Cardiac Catheterization Laboratory

Usefulness of balloon angioplasty for the right ventricle‐pulmonary artery shunt with the modified norwood procedure

A 10-year single-centre experience in percutaneous interventions for multi-stage treatment of hypoplastic left heart syndrome

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