Hybrid intraoperative pulmonary artery stenting in redo congenital cardiac surgeries

Abstract

Hybrid stenting of branch PA is a safe and effective option for PA reconstruction in redo cardiac surgeries. With meticulous planning, it can be safely performed without fluoroscopy.

Long-Term Outcomes After Surgical Pulmonary Arterioplasty and Risk Factors for Reintervention

“…Nearly half of all reinterventions performed in this study required percutaneous stent placement, which exposes patients to radiation and sometimes prolonged catheterization procedures [12]. Intraoperative stent placement has shown promising results in children and may circumvent some of the challenges to percutaneous stent placement in this population [1,[13][14][15][16][17]. Although stents in growing children need redilation to account for somatic growth or in-stent stenosis, stent dilation is often a less complex procedure than the initial percutaneous stent implantation.…”

Intraoperative Stenting of Pulmonary Artery Stenosis in Children With Congenital Heart Disease

“…Our study confirms the efficiency and the safety of intraoperative BPA stenting to remove PA stenosis and prevent recurrence. Hybrid PA stenting has been proposed as an alternative to percutaneous stenting and surgical angioplasty in cases of limited vascular access, complex anatomy, or concomitant surgery for additional surgical issues [6,10,11,[14][15][16][17]. It has also been used to avoid prolonged cardiopulmonary bypass, reduce the number of interventions, and reduce the operative complexity [16].…”

“…Fluoroscopy can be used during the procedure to ensure proper stent positioning. Intraoperative fluoroscopy was not possible in our center as stenting was performed in the operating room, as in most studies dealing with intraoperative stent implantation [10,14,15]. However, all stents were well positioned when verified.…”

Twenty years of experience with intraoperative pulmonary artery stenting

“…Intraoperative PA stent placement is an alternative approach. This procedure has been shown to be safe with excellent short‐term efficacy . It can allow for implantation of stents that can be dilated to adult size that would be difficult to place percutaneously in small children, while avoiding ionizing radiation exposure from cardiac catheterization procedures.…”