Stenting for superior vena cava obstruction in pediatric heart transplant recipients

Sachdeva, Ritu; Seib, Paul M.; Burns, Samuel A.; Fontenot, Eudice E.; Frazier, Elizabeth A.

doi:10.1002/ccd.21296

Cited by 15 publications

(22 citation statements)

References 6 publications

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“…Balloon dilation and/or stent implantation have been reported to be effective in SVC obstruction in several case series and small reports (13,(24)(25)(26)(27)(28)(29). In this study, we reported our experience with SVC intervention in patients previously supported with neonatal ECMO, a subset of patients who have not been specifically studied in prior reports.…”

Section: Transcatheter Treatment Of Svc Obstructionmentioning

confidence: 63%

Obstruction of the Superior Vena Cava After Neonatal Extracorporeal Membrane Oxygenation

Kazancı

McElhinney

Thiagarajan

et al. 2013

Pediatric Critical Care Medicine

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Among neonates treated with extracorporeal membrane oxygenation, superior vena cava obstruction is associated with an increased risk of chylothorax. In neonates with chylothorax after extracorporeal membrane oxygenation, evaluation for superior vena cava obstruction may be warranted. Although mortality is high in this population, transcatheter treatment can relieve superior vena cava obstruction and facilitate symptomatic improvement.

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Section: Transcatheter Treatment Of Svc Obstructionmentioning

confidence: 63%

Obstruction of the Superior Vena Cava After Neonatal Extracorporeal Membrane Oxygenation

Kazancı

McElhinney

Thiagarajan

et al. 2013

Pediatric Critical Care Medicine

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“…23,24 There are few published reports on the incidence of SVC obstruction in transplant recipients and on the role of previous CPA as an independent risk factor for SVC obstruction after OHT. Although some reports highlight the association of SVC obstruction following CPA in both transplant 7,25 and nontransplant patients, other publications do not confirm this association. 27,28 …”

Section: Discussionmentioning

confidence: 94%

“…Superior vena cava (SVC) obstruction has emerged as a notable complication following OHT, particularly with the bicaval method of graft implantation. 1–3 It has been postulated that younger age at transplantation, donor—recipient caval mismatch, 4,5 and previous surgery involving the SVC, 6 and previous superior cavopulmonary anastomosis (CPA) 7 may be risk factors for posttransplant SVC obstruction. However, the incidence of SVC obstruction in pediatric heart transplant patients and the effect of pretransplant exposure to previous superior CPA or other types of non-CPA SVC surgeries remain unknown.…”

mentioning

confidence: 99%

Frequency of Superior Vena Cava Obstruction in Pediatric Heart Transplant Recipients and Its Relation to Previous Superior Cavopulmonary Anastomosis

Aldoss¹,

Arain²,

Vinocur³

et al. 2013

The American Journal of Cardiology

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The risk factors for superior vena cava (SVC) obstruction after pediatric orthotopic heart transplantation (OHT) have not been identified. This study tested the hypothesis that pretransplant superior cavopulmonary anastomosis (CPA) predisposes patients to SVC obstruction. A retrospective review of file Pediatric Cardiac Care Consortium registry from 1982 through 2007 was performed. Previous CPA, other cardiac surgeries, gender, age at transplantation, and weight at transplantation were assessed for the risk of developing SVC obstruction. Death, subsequent OHT, or reoperation involving the SVC were treated as competing risks. Of the 894 pediatric OHT patients identified, 3.1% (n = 28) developed SVC obstruction during median follow-up of 1.0 year (range: 0 to 19.5 years). Among patients who developed SVC obstruction, 32% (n = 9) had pretransplant CPA. SVC surgery before OHT was associated with posttransplant development of SVC obstruction (p <0.001) after adjustment for gender, age, and weight at OHT and year of OHT. Patients with previous CPA had increased risk for SVC obstruction compared with patients with no history of previous cardiac surgery (hazard ratio 10.6,95% confidence interval: 3.5 to 31.7) and to patients with history of non-CPA cardiac surgery (hazard ratio 4.7,95% confidence interval: 1.8 to 12.5). In conclusion, previous CPA is a significant risk factor for the development of post—heart transplant SVC obstruction. Published by Elsevier Inc. (Am J Cardiol 2013;112:286–291)

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“…[561][562][563][564][565][566][567][568][569][570][571][572][573] Although stents can be successfully used in infants aged , 1 year, the small vessel size increases the risk of thrombosis. 574 There are no studies assessing the role of anticoagulation or antiplatelet therapy to avoid stent occlusion in children.…”

Section: 40-242 Biologic and Mechanical Prosthetic Heart Valvesmentioning

confidence: 99%

Antithrombotic Therapy in Neonates and Children

Monagle

Chan

Goldenberg

et al. 2012

Chest

1,269

559

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Stenting for superior vena cava obstruction in pediatric heart transplant recipients

Abstract: SVC obstruction can be an important complication following heart transplantation, especially in infants with previous cavopulmonary anastomosis, undergoing heart transplant using bicaval technique. SVC obstruction can be safely and effectively treated using endovascular stents.

Cited by 15 publications

References 6 publications

Obstruction of the Superior Vena Cava After Neonatal Extracorporeal Membrane Oxygenation

Obstruction of the Superior Vena Cava After Neonatal Extracorporeal Membrane Oxygenation

Frequency of Superior Vena Cava Obstruction in Pediatric Heart Transplant Recipients and Its Relation to Previous Superior Cavopulmonary Anastomosis

Antithrombotic Therapy in Neonates and Children

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