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Ductal stenting to improve pulmonary blood flow in pulmonary atresia with intact ventricular septum and critical pulmonary stenosis after balloon valvuloplasty

Published online by Cambridge University Press:  29 April 2019

Raymond N. Haddad Open the ORCID record for Raymond N. Haddad [Opens in a new window] ,
Najib Hanna ,
Ramy Charbel ,
Linda Daou ,
Ghassan Chehab  and
Zakhia Saliba
Raymond N. Haddad*
Affiliation:
Department of Pediatrics, Hotel-Dieu de France University Medical Center, Saint Joseph University, Alfred Naccache Boulevard, Achrafieh, Beirut, Lebanon
Najib Hanna
Affiliation:
Department of Pediatric Cardiology, Hotel-Dieu de France University Medical Center, Saint Joseph University, Alfred Naccache Boulevard, Achrafieh, Beirut, Lebanon
Ramy Charbel
Affiliation:
Department of Pediatrics, Hotel-Dieu de France University Medical Center, Saint Joseph University, Alfred Naccache Boulevard, Achrafieh, Beirut, Lebanon
Linda Daou
Affiliation:
Department of Pediatric Cardiology, Hotel-Dieu de France University Medical Center, Saint Joseph University, Alfred Naccache Boulevard, Achrafieh, Beirut, Lebanon
Ghassan Chehab
Affiliation:
Department of Pediatric Cardiology, Hotel-Dieu de France University Medical Center, Saint Joseph University, Alfred Naccache Boulevard, Achrafieh, Beirut, Lebanon
Zakhia Saliba
Affiliation:
Department of Pediatric Cardiology, Hotel-Dieu de France University Medical Center, Saint Joseph University, Alfred Naccache Boulevard, Achrafieh, Beirut, Lebanon
*
Author for correspondence: Raymond Haddad, MD, Department of Pediatrics, Hotel-Dieu de France University Medical Center, Saint Joseph University, Alfred Naccache Boulevard, Achrafieh, Beirut, Lebanon BP: 166830. Tel: +961 70 605 800; Fax: +961 (1) 604 976; E-Mail: [email protected]
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Abstract

Objective:

To assess the feasibility, safety, and efficiency of ductal stenting in pulmonary atresia with intact ventricular septum or critical pulmonary stenosis after balloon pulmonary valvuloplasty.

Background:

Ductal stenting in pulmonary atresia with intact ventricular septum is a re-emerging and promising technique. There is little data available on its outcomes after establishing prograde pulmonary blood flow.

Methods:

We retrospectively reviewed all neonates with pulmonary atresia with intact ventricular septum or critical pulmonary stenosis who underwent ductal stenting after balloon valvuloplasty. Ductal stenting was performed either in the same setting (group A) or a few days later after balloon valvuloplasty (group B). We compared the two groups.

Results:

Eighteen coronary stents were transvenously delivered and successfully deployed in 18 newborns. There was no procedure-related mortality. The median hospital stay post-intervention was 6 days with a mean discharge oxygen saturation of 94%. Group A had a shorter overall hospital stay with a shorter overall time of irradiation but with a longer overall procedural time. On a follow-up of 18 months, no re-intervention for stent failure or overflow was undertaken. The median stent patency based on echocardiography was 12 months.

Conclusion:

Stenting the arterial duct in pulmonary atresia with intact ventricular septum or critical pulmonary stenosis is a feasible, safe, and efficient technique. It avoids surgery or long hospital stay with prostaglandin infusion. The minimal 6 months stent longevity provides a period of time long enough to decide whether the right ventricular diastolic function is normalised or Glenn surgery is still needed.

Keywords

Stentpulmonary atresiainterventricular septumarterial ductal
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 4 , April 2019 , pp. 492 - 498
Copyright
© Cambridge University Press 2019 

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Footnotes

*

Authorship Declaration: All authors listed meet the authorship criteria according to the latest guidelines of the international committee of Medical journal editors, and that all authors are in agreement with the manuscript.

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