Stenting the arterial duct in neonates and infants with congenital heart disease and duct‐dependent pulmonary blood flow: A multicenter experience of an evolving therapy over 18 years

Abstract

The technical aspects and clinical application of percutaneous DS has changed in the last two decades. DS has become a practical and safe therapy in a subgroup of neonates with ductal-dependent pulmonary blood flow.

Ten‐years, single‐center experience with arterial duct stenting in duct‐dependent pulmonary circulation: Early results, learning‐curve changes, and mid‐term outcome

“…Our data confirm that percutaneous AD stenting is highly feasible at low risk in the vast majority of patients with CHD‐DPC. As in other series , ductal tortuosity was the major cause of procedural failure or need for elective surgical shunt after a seemingly effective stenting. In this setting, using the closest and straightest vascular entry to the duct may be crucial to negotiate the vessel and straighten it with stiff guide‐wires as well as to finely deploy the stent by checking its length and position by repeat control angiographies.…”

“…This option has been advocated either in high‐risk patients unsuitable for primary repair or whenever short‐term pulmonary blood flow support is anticipated. However, despite large worldwide experiences, current knowledge about indications, early results and mid‐term outcome of this approach still largely depends on small series , larger experiences in particular subsets of patients or multicenter series based on different philosophy and interventional technique .…”

Results of Primary Repair Versus Shunt Palliation in Ductal Dependent Infants With Pulmonary Atresia and Ventricular Septal Defect

“…Additionally, the small cohort size and the multiple variables in this series all preclude sophisticated statistical analyses and limit the power of the study to identify clinically significant risk factors. Finally, the role of different treatment approaches such as initial ductal stenting or performance of RV-PA shunt as an alternative mode of palliation of ductal-dependent PAVSD could not be assessed in the current series although there have been some recent reports suggesting the utility of those different approaches [17][18][19][20].…”

Achieving biventricular circulation in patients with moderate hypoplastic right ventricle in pulmonary atresia intact ventricular septum after transcatheter pulmonary valve perforation

“…Pertaining to strategies to mitigate the need of early reintervention, simultaneous duct stenting has been reported as an attractive strategy for patients with moderate RV hypoplasia or the so‐called borderline RVs in providing additional source of pulmonary blood flow during the procedure of transcatheter valve perforation . However, the decision for ductal stenting was largely under the discretion of individual operators in some of these studies.…”