Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-28T02:25:09.606Z Has data issue: false hasContentIssue false
  • English
  • Français

Transcatheter stenting of the right ventricular outflow tract augments pulmonary arterial growth in symptomatic infants with right ventricular outflow tract obstruction and hypercyanotic spells

Published online by Cambridge University Press:  04 March 2016

Eimear McGovern ,
Conall T. Morgan ,
Paul Oslizlok ,
Damien Kenny ,
Kevin P. Walsh  and
Colin J. McMahon
Eimear McGovern
Affiliation:
Department of Paediatric Cardiology, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
Conall T. Morgan
Affiliation:
Department of Paediatric Cardiology, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
Paul Oslizlok
Affiliation:
Department of Paediatric Cardiology, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
Damien Kenny
Affiliation:
Department of Paediatric Cardiology, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
Kevin P. Walsh
Affiliation:
Department of Paediatric Cardiology, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
Colin J. McMahon*
Affiliation:
Department of Paediatric Cardiology, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
*
Correspondence to: Dr C. J. McMahon, FRCPI Cardiac Department, Our Lady’s Children’s Hospital, Crumlin, Dublin 12, Ireland. Tel: +01 4096160; Fax: +01 4096181; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

We retrospectively reviewed all the children with right ventricular outflow tract obstruction, hypoplastic pulmonary annulus, and pulmonary arteries who underwent stenting of the right ventricular outflow tract for hypercyanotic spells at our institution between January, 2008 and December, 2013; nine patients who underwent cardiac catheterisation at a median age of 39 days (range 12–60 days) and weight of 3.6 kg (range 2.6–4.3 kg) were identified. The median number of stents placed was one stent (range 1–4). The median oxygen saturation increased from 60% to 96%. The median right pulmonary artery size increased from 3.3 to 5.5 mm (−2.68 to −0.92 Z-score), and the median left pulmonary artery size increased from 3.4 to 5.5 mm (−1.93 to 0 Z-scores). Among all, one patient developed transient pulmonary haemorrhage, and one patient had pericardial tamponade requiring drainage. Complete repair of tetralogy of Fallot +/− atrioventricular septal defect or double-outlet right ventricle was achieved in all nine patients. Transcatheter stent alleviation of the right ventricular outflow tract obstruction resolves hypercyanotic spells and allows reasonable growth of the pulmonary arteries to facilitate successful surgical repair. This represents a viable alternative to placement of a systemic-to-pulmonary artery shunt, particularly in small neonates.

Keywords

Hypercyanotic spelltetralogy of Fallotright ventricular outflow tractstent
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 7 , October 2016 , pp. 1260 - 1265
Check for updates
Copyright
© Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Cools, B, Boshoff, D, Heying, R, Rega, F, Meyns, B, Gewillig, M. Transventricular balloon dilation and stenting of the RVOT in small infants with tetralogy of Fallot with pulmonary atresia. Catheter Cardiovasc Interv 2013; 82: 260–265.Google Scholar
2. Laudito, A, Bandisode, VM, Lucas, JF, Radtke, WA, Adamson, WT, Bradley, SM. Right ventricular outflow tract stent as a bridge to surgery in a premature infant with tetralogy of Fallot. Ann Thorac Surg 2006; 81: 744–746.Google Scholar
3. Bang, S, Ko, HK, Yu, JJ, et al. Right ventricular outflow tract stenting in a low birth weight infant born with tetralogy of Fallot and prostaglandin e1 dependency. Korean Circ J 2011; 41: 744–746.Google Scholar
4. Dohlen, G, Chaturvedi, RR, Benson, LN, et al. Stenting of the right ventricular outflow tract in the symptomatic infant with tetralogy of Fallot. Heart 2009; 95: 142–147.Google Scholar
5. Gibbs, JL, Uzun, O, Blackburn, ME, Parsons, JM, Dickinson, DF. Right ventricular outflow stent implantation: an alternative to palliative surgical relief of infundibular pulmonary stenosis. Heart 1997; 77: 176–179.Google Scholar
6. Stumper, O, Ramchandani, B, Noonan, P, et al. Stenting of the right ventricular outflow tract. Heart 2013; 99: 1603–1608.Google Scholar
7. Pettersen, MD, Du, W, Skeens, ME, Humes, RA. Regression equations for calculation of z scores of cardiac structures in a large cohort of healthy infants, children and adolescents: an echocardiographic study. J Am Soc Echocardiogr 2008; 21: 922–934.Google Scholar
8. Lee, SY, Song, JY, Choi, EY, Baek, JS. Palliation using a self-expandable stent in a patient with obstructive right-ventricular outflow tract after total correction of tetralogy of Fallot: self-expandable stent in tetralogy of Fallot. Pediatr Cardiol 2012; 33: 1446–1449.Google Scholar
9. Ishikawa, S, Takahashi, T, Sato, Y, et al. Growth of the pulmonary arteries after systemic-pulmonary shunt. Ann Thorac Cardiovasc Surg 2001; 7: 337–340.Google Scholar
10. Al Habib, HF, Jacobs, JP, Mavroudis, C, et al. Contemporary patterns of management of tetralogy of Fallot: data from the society of thoracic surgeons database. Ann Thorac Surg 2010; 90: 813–819.Google Scholar