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Balloon angioplasty of bidirectional Glenn anastomosis

Published online by Cambridge University Press:  11 August 2020

Amr Matoq Open the ORCID record for Amr Matoq [Opens in a new window]  and
Wolfgang Radtke
Amr Matoq
Affiliation:
Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, DE19803, USA
Wolfgang Radtke*
Affiliation:
Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, DE19803, USA
*
Author for correspondence: Wolfgang Radtke MD, Nemours Cardiac Center, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Rd, Wilmington, DE19803, USA. Tel: +1 302 651 6600; Fax: +1 302 651 6600. E-mail: [email protected]
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Abstract

Objective:

We aim to assess the safety and efficacy of the transcatheter balloon dilation of superior cavopulmonary anastomosis (SCPA).

Background:

SCPA stenosis can lead to impaired pulmonary blood flow, hypoxemia and development of veno-venous collaterals with right-to-left shunt. Balloon dilation of SCPA has been rarely reported and follow-up information is lacking.

Methods:

We performed a retrospective review of patients who underwent cardiac catheterisation and angioplasty of SCPA and reviewed patient’s demographics, diagnosis, SCPA surgery and post-operative course, catheterisation haemodynamics, procedural technique, angiography, and the findings of follow-up catheterisation.

Results:

Between 2008 and 2017, seven patients showed significant narrowing of SCPA and underwent balloon angioplasty, all of whom had undergone bidirectional Glenn (BDG). Indications for cardiac catheterisation included persistent pleural effusion, hypoxemia, and echocardiographic evidence of BDG stenosis or routine pre-Fontan assessment. Five patients had bilateral SCPA. The procedure was successful in all cases with increase in the stenosis diameter from a median of 3.3 mm (range 1.2–4.7 mm) to a median of 4.7 mm (range 2.6–7.8 mm). All patients had at least one follow-up cardiac catheterisation. Only one patient required repeat angioplasty at the 2.3-month follow-up with no further recurrence. Sustained results and interval growth were noted in all other cases during up to 29 months of follow-up. No adverse events were encountered.

Conclusion:

Based on our small series, balloon angioplasty of BDG stenosis is feasible and safe and appears to provide sustained improvement with interval growth and only the rare recurrence of stenosis.

Keywords

Single ventricleveno-venous collateralsstenosis
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 10 , October 2020 , pp. 1452 - 1457
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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