Stent Implantation of the Arterial Duct in Newborns with a Truly Duct‐Dependent Pulmonary Circulation: A Single‐Center Experience with Emphasis on Aspects of the Interventional Technique

Schranz, Dietmar; Michel‐Behnke, Ina; Heyer, Rajka; Vogel, M; Bauer, Jürgen; Valeske, K.; Akintürk, Hakan; Jux, Christian

doi:10.1111/j.1540-8183.2010.00576.x

Cited by 71 publications

(67 citation statements)

References 14 publications

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“…Consequently neither procedure has emerged as superior, with 15 preference tending to center around the chosen practice of individual programs. In the last few 16 years there has been an increase in the number of arterial duct stent procedures performed as 17 well as an acceptance that the difficult experiences of the early procedures have resulted in 18 some standardization of equipment and approach [6][7][8][9] . It is timely and appropriate to seek to 19 compare the two procedures given that appreciable early mortality continues to be reported 20 for both 5,10 .…”

mentioning

confidence: 99%

Duct Stenting Versus Modified Blalock-Taussig Shunt in Neonates With Duct-Dependent Pulmonary Blood Flow

et al. 2018

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mentioning

confidence: 99%

Duct Stenting Versus Modified Blalock-Taussig Shunt in Neonates With Duct-Dependent Pulmonary Blood Flow

et al. 2018

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“…Many neonates in developing place around world could not be diagnosed for complex congenital heart disease in fetus stage, and it is hard for them to be transported to top heart center for operation if these complications occur after E-type prostaglandins infusion. Also, PDA stenting is not only technically difficult [20], especially in the case of a very tortuous DA, but is also less durable than a conventional surgical shunt [18]. Therefore, the identification of mechanisms by which the DA remains patent is of great clinical relevance and also could prove useful in developing novel therapies for the treatment of congenital cardiovascular diseases.…”

Section: Introductionmentioning

confidence: 99%

“…The DA can be maintained in a state of patency by treatment with E-type prostaglandins or percutaneous stent implantation [8,20,21]. However, treatment with a low dose of E-type prostaglandins causes complications in more than 50 % of patients, including necrotizing enterocolitis, apnoea/bradycardia, and hypotension [21].…”

Section: Introductionmentioning

confidence: 99%

Elevated NCX1 and NCKX4 Expression in the Patent Postnatal Ductus Arteriosus of Ductal-Dependent Congenital Heart Disease Patients

et al. 2014

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Patency of the ductus arteriosus (DA) after birth is essential in ductal-dependent congenital heart disease. The Na(+)/Ca(2+) exchanger (NCX) has been demonstrated to play a key role in regulating vascular tone. The potassium-dependent Na(+)/Ca(2+) exchanger (NCKX) is a related family of NCX depending on the K(+) gradients which triggers DA constriction. The present study investigated the comparative expression of NCX and NCKX between a constricted DA and patent DA in human ductal-dependant congenital heart disease. Human DAs, which were patent (n = 10, age = 20.2 ± 4.3 days) or constricted (n = 10, age = 18.3 ± 3.9 days), were excised during surgery from neonates with ductal-dependent congenital heart disease. Western blotting analysis, real-time quantitative polymerase chain reaction analysis and immunofluorescence studies were performed to detect the protein and mRNA levels of NCX1, NCKX3, and NCKX4. The expressions of NCX1 and NCKX4 were significantly higher in the patent DA group at both the protein and mRNA levels, and expression was localized to the smooth muscle layer. These findings indicate that NCX1 and NCKX4 are up-regulated in human postnatal patent DAs and may represent potential therapeutic targets for maintaining DA patency in ductal-dependent congenital heart disease.

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“…(3) Other reported peri-procedural complications include acute stent thrombosis (2 -3%), pre-stent ductal spasm (<1%), stent dislodgement and migration, vessel or chamber perforation and neointimal proliferation of which the overall incidence is low. (3,8,11,12,14) Long term complications resemble those of surgical shunts and consist of progressive stent stenosis, pulmonary overflow with pulmonary hypertension and branch pulmonary artery distortion.…”

Section: Limitations Of Pda Stentingmentioning

confidence: 99%

“…(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) The majority of patients underwent patent ductus arteriosus (PDA) stenting at an early age, usually shortly after birth, with weights ranging between 1.5 -4.5kg.…”

Section: Immediate Outcomes Of Pda Stentingmentioning

confidence: 99%

Stenting the arterial duct: Practical aspects and review of outcomes

Buys

Brown

Greig

2017

SAHJ

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Maintaining ductus arteriosus patency by the percutaneous placement of coronary artery stents provides an alternative to surgical systemic-to-pulmonary artery shunts. This maintains pulmonary blood flow and serves as a temporary bridge towards later surgical repair. Since the first report by Gibbs, et al. in 1992, the success and outcome of ductal stenting have improved due to advances in technique and equipment. This is now considered an acceptable option for these patients in many centres. OUTCOMES OF DUCTUS ARTERIOSUS STENTING: A REVIEW OF CURRENT LITERATURE Immediate outcomes of PDA stentingA detailed description of the immediate outcomes of PDA stenting can be viewed in Table 1. (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) The majority of patients underwent patent ductus arteriosus (PDA) stenting at an early age, usually shortly after birth, with weights ranging between 1.5 -4.5kg.Procedural success was good and stent placement was successful in 80 to 100% of the cases. The effectiveness of the procedure is highlighted by the fact that all studies have shown a significant improvement in arterial saturations after stent placement. Some cases have required more than 1 stent in an attempt to ensure adequate coverage of the entire ductal length. Reported periprocedural complication rates were low: major complications included stent migration, acute thrombosis and permanent femoral vessel damage. Very few immediate deaths were directly related to

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Stent Implantation of the Arterial Duct in Newborns with a Truly Duct‐Dependent Pulmonary Circulation: A Single‐Center Experience with Emphasis on Aspects of the Interventional Technique

Cited by 71 publications

References 14 publications

Duct Stenting Versus Modified Blalock-Taussig Shunt in Neonates With Duct-Dependent Pulmonary Blood Flow

Duct Stenting Versus Modified Blalock-Taussig Shunt in Neonates With Duct-Dependent Pulmonary Blood Flow

Elevated NCX1 and NCKX4 Expression in the Patent Postnatal Ductus Arteriosus of Ductal-Dependent Congenital Heart Disease Patients

Stenting the arterial duct: Practical aspects and review of outcomes

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