Right ventricular outflow tract stenting in double outlet right ventricle with critical pulmonary stenosis and hypoplastic pulmonary arteries

Kwaśniak, Ewelina; Haponiuk, Ireneusz; Chojnicki, Maciej; Jaworski, Radosław; Szofer-Sendrowska, Aneta; Steffens, Mariusz

doi:10.5114/aic.2016.61651

Cited by 3 publications

(4 citation statements)

References 3 publications

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“…Previously, most RVOT stenting research focused on the effects of saturation and pulmonary artery growth in babies ( 22 – 26 ). However, in this investigation, we discovered an intriguing occurrence in which saturation and ejection fraction improved dramatically, particularly in adults with unrepaired Fallot physiology.…”

Section: Discussionmentioning

confidence: 99%

“…Arrhythmia, cerebrovascular accident, tamponade, stent thrombosis, malposition and embolisation, and vascular access problems such as hemorrhage and thrombosis have previously been documented following RVOT stent insertion. Post-procedural problems were confined to a transitory conduction disruption, clinically inconsequential RVOT perforation, and proximal stent embolisation ( 22 – 26 ). We also discovered various issues in adult populations, such as fractured or dislodged stents, which we believe are caused by hypertrophied infundibular stenosis.…”

Section: Discussionmentioning

confidence: 99%

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Right ventricular outflow tract stenting for late presenter unrepaired Fallot physiology: a single-center experience

Prakoso,

Kurniawati,

Siagian

et al. 2024

Front. Cardiovasc. Med.

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ObjectivesThe purpose of this study was to assess the clinical outcome after right ventricular outflow tract (RVOT) stenting in late presenter patient with unrepaired Fallot physiology.BackgroundIn younger patients, RVOT stenting is an alternative to mBTT shunt; however, there have been few reports of this palliative technique in late presenter population, including adults.MethodsThis was a single-center, retrospective study of nonrandomized, palliated Fallot patients. Clinical outcomes such as left ventricular ejection fraction and saturation were measured in 32 individuals following RVOT stenting in adults (n = 10) and children (n = 22). The Statistical Package for Social Science (SPSS) 26.0 software was used to analyze the statistical data.ResultsDuring the procedure, the average stent diameter and length were 8.84 ± 1.64 mm and 35.46 ± 11.23 mm, respectively. Adult patients received slightly longer stents than pediatric patients (43.60 ± 11.64 mm vs. 31.77 ± 9.07 mm). Overall, patients' saturation increased from 58.56 ± 19.03% to 91.03 ± 8.98% (p < 0.001), as did their left ventricular ejection fraction (LVEF) from 64.00 ± 18.21% to 75.09 ± 12.98% (p = 0.001). Three patients improved their LVEF from 31 to 55%, 31 to 67%, and 26 to 50%. The median length of stay was 8 (2–35) days, with an ICU stay of 2 (0–30) days. The median time from RVOT stent palliation to total repair was 3 months (range: 1 month–12 months).ConclusionsRVOT stenting is a safe and effective method for increasing saturation and ejection fraction not only in newborn infants but also in late presenters, including adults with unrepaired Fallot physiology.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Right ventricular outflow tract stenting for late presenter unrepaired Fallot physiology: a single-center experience

Prakoso,

Kurniawati,

Siagian

et al. 2024

Front. Cardiovasc. Med.

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“…Kwa sniak et al described a clinical case of RVOT stenting in a newborn with DORV, followed by Blalock-Taussig shunting and 14 months of successful follow-up. 45 The similar procedure for RVOT obstruction although without subsequent Blalock-Taussig shunting was performed by Oztürk et al in a 3-months old patient with Edwards syndrome and DORV who was unfortunately lost from the follow-up. 46 Lacour-Gayet F. provided the pre-operative checklist for patients with DORV.…”

Section: Surgical Treatment Of Dorvmentioning

confidence: 99%

“…Stenting in children and adolescents is limited by the perspectives of growing heart, hence the interventional surgery is relevant for adult patients. Kwaśniak et al described a clinical case of RVOT stenting in a newborn with DORV, followed by Blalock–Taussig shunting and 14 months of successful follow‐up 45 . The similar procedure for RVOT obstruction although without subsequent Blalock–Taussig shunting was performed by Oztürk et al in a 3‐months old patient with Edwards syndrome and DORV who was unfortunately lost from the follow‐up 46…”

Section: Introductionmentioning

confidence: 99%

Double outlet right ventricle in adults: Anatomic variability, surgical treatment, and late postoperative complications

Karev

Stovpyuk

2022

J of Clinical Ultrasound

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Double outlet right ventricle (DORV) is a highly complex congenital heart disease (CHD) entity, gaining increasing interest due to the rapid progress of cardiac surgery. The number of patients operated for this congenital defect has been growing since 1980s and over following decades with active transitioning of this cohort into the adult medicine. However, the diversity of initial anomaly and performed interventions makes challenging the management of these patients. This is particularly important in the regions where specialized adult CHD cardiology still remains underdeveloped. In this review, we observe the basic principles of DORV nomenclature, main types of the operations and possible late complications. The article focuses on adult patients and offers illustrations from clinical practice.

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Narrative review of assessing the surgical options for double outlet right ventricle

2021

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The individualized surgical approach in individuals with both arterial trunks arising from the morphologically right ventricle is dictated by the extreme morphological variability encountered in this setting, with each patient being unique. An individualized surgical approach has been designed to take account of the morphological variations, identifying the anatomy with the preoperative three-dimensional CT scan reconstruction. The key features have been considered the distance between tricuspid and pulmonary valves, the size and location of the interventricular communication, and the relationship between the outflow tracts. The surgical approach is tailored, whenever feasible, to create a connection between left ventricle and aorta, but primarily to achieve biventricular repair. Account has been taken of all available surgical options already reported in the literature, identifying the most suitable to provide the best outcomes for each unique morphology. To date, meaningful comparison between different reported surgical series has been difficult because of the marked variation of individual intracardiac morphology, and the lack of reports of specific surgical approaches for well-categorized groups of patients. Our approach, being tailored to the individual cardiac morphology, can be offered to any patient with this ventriculo-arterial connection.Given the difficulties of diagnosis, and the multiple therapeutic indications, very close collaboration between cardiologists and surgeons is indispensable for further progress in the understanding and management of this complex congenital cardiac lesion.

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Right ventricular outflow tract stenting in double outlet right ventricle with critical pulmonary stenosis and hypoplastic pulmonary arteries

Cited by 3 publications

References 3 publications

Right ventricular outflow tract stenting for late presenter unrepaired Fallot physiology: a single-center experience

Right ventricular outflow tract stenting for late presenter unrepaired Fallot physiology: a single-center experience

Double outlet right ventricle in adults: Anatomic variability, surgical treatment, and late postoperative complications

Narrative review of assessing the surgical options for double outlet right ventricle

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