Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-25T02:22:13.406Z Has data issue: false hasContentIssue false
  • English
  • Français

Early and midterm results of ductal stent implantation in neonates with ductal-dependent pulmonary circulation: a single-centre experience

Published online by Cambridge University Press:  03 September 2020

Mehmet Akif Onalan Open the ORCID record for Mehmet Akif Onalan [Opens in a new window] ,
Ender Odemis ,
Murat Saygi ,
Bahar Temur ,
Selim Aydin ,
Ibrahim Halil Demir  and
Ersin Erek
Mehmet Akif Onalan*
Affiliation:
Faculty of Medicine, Department of Cardiovascular Surgery, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
Ender Odemis
Affiliation:
Faculty of Medicine, Department of Pediatric Cardiology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
Murat Saygi
Affiliation:
Faculty of Medicine, Department of Pediatric Cardiology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
Bahar Temur
Affiliation:
Faculty of Medicine, Department of Cardiovascular Surgery, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
Selim Aydin
Affiliation:
Faculty of Medicine, Department of Cardiovascular Surgery, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
Ibrahim Halil Demir
Affiliation:
Faculty of Medicine, Department of Pediatric Cardiology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
Ersin Erek
Affiliation:
Faculty of Medicine, Department of Cardiovascular Surgery, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
*
Author for correspondence: Mehmet Akif Onalan, MD, Faculty of Medicine, Department of Cardiovascular Surgery, Acibadem Mehmet Ali Aydinlar University, 34303Halkalı, Istanbul, Turkey. Tel: +90 212 404 47 31; Fax: +90 2124044797. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

We aimed to determine the early and midterm outcomes of ductal stenting in neonates with ductal-dependent pulmonary blood flow.

Methods:

Between January, 2014 and July, 2018, 102 patients who underwent 115 cardiac catheterisation procedures for ductal stent implantation in our department were retrospectively reviewed. The age of the neonates ranged from 3 to 30 days (median: 11 days) and their weights ranged from 1.8 to 5.8 kg (mean, 2.8 ± 0.53 kg). Fifty-two patients had functional single ventricle and 50 had biventricular physiology. Thirty-one patients’ weights were <2,500 g (30.3%). The patent ductus arteriosus was vertical in 60 patients (58.8%). The mean ductal length was 12.4 ± 4.1 mm (range, 7.8–23 mm), and the mean narrowest ductal diameter was 2.1 ± 0.7 mm (range, 1.2–3.4 mm).

Results:

The technical success rate was 85.2%. Procedure-related mortality occurred in three patients (2.9%). After the procedure, the aortic oxygen saturation increased from a mean of 73.1 ± 6.2% to a mean of 90.4 ± 4.3% (p < 0.001), and the ductus diameter increased from a mean of 2.1 ± 0.7 mm to a mean of 4.2 ± 0.9 mm (p < 0.001). Either transcatheter or surgical reinterventions were required in 35 patients (34.3%) during the follow-up period after a median of 101 days (2–356 days). Thirty-three patients (32.3%) were bridged to surgical repair after a median of 288 days (163–650 days). The median duration of palliation with ductal stents was 210 days (range, 2–525 days).

Conclusion:

Ductus arteriosus stenting may be a reasonable and effective alternative to surgery for the initial palliation procedure in neonates with ductus-dependent pulmonary flow.

Keywords

CHDductal stentingoutcome
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 12 , December 2020 , pp. 1772 - 1782
Check for updates
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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

Sivakumar, K, Shivaprakasha, K, Rao, SG, Krisha Kumar, R. Operative outcome and intermediate term follow up of neonatal Blalock-Taussig shunts. Indian Heart J 2001; 53: 66–70.Google ScholarPubMed
Petrucci, O, O’Brien, SM, Jacobs, ML, Jacobs, JP, Manning, PB, Eghtesady, P. Risk factors for mortality and morbidity after the neonatal Blalock-Taussig shunt procedure. Ann Thorac Surg 2011; 92: 642–651.CrossRefGoogle ScholarPubMed
Erek, E, Yalcinbas, YK, Mamur, Y, et al. Systemic-to-pulmonary shunt operation in neonates with ductus-dependent pulmonary blood flow. Turk J Thoracic Cardiovasc Surg 2007;15: 29–35.Google Scholar
Santoro, G, Gaio, G, Palladino, MT, et al. Stenting of the arterial duct in newborn with duct-dependent pulmonary circulation. Heart 2008; 94: 925–929.CrossRefGoogle ScholarPubMed
Gibbs, JL, Uzun, O, Blackburn, ME, Wren, C, Hamilton, JR, Watterson, KG. The fate of the stented arterial duct. Circulation 1999; 99: 2621–2625.CrossRefGoogle Scholar
Coe, J, Olley, P. A novel method to maintain ductus arteriosus patency. J Am Coll Cardiol 1991; 18: 837–841.CrossRefGoogle ScholarPubMed
Alwi, M. Stenting the ductus arteriosus: case selection, technique and possible complications. Ann Pediatr Cardiol 2008; 1: 38–45.7.CrossRefGoogle ScholarPubMed
Sivakumar, K, Bhagyavathy, A, Coelho, R, Satish, R, Krishnan, P. Longevity of neonatal ductal stenting for congenital heart diseases with duct-dependent pulmonary circulation. Congenit Heart Dis 2012; 7: 526–533.CrossRefGoogle ScholarPubMed
Odemis, E, Haydin, S, Guzeltas, A, Ozyilmaz, I, Bilici, M, Bakir, I. Stent implantation in the arterial duct of the newborn with duct-dependent pulmonary circulation: single centre experience from Turkey. Eur J Cardiothorac Surg 2012; 42: 57–60.CrossRefGoogle ScholarPubMed
Haddad, RN, Hanna, N, Charbel, R, Daou, L, Chehab, G, Saliba, Z. Ductal stenting to improve pulmonary blood flow in pulmonary atresia with intact ventricular septum and critical pulmonary stenosis after balloon valvuloplasty. Cardiology in the Young 2019; 29: 492–498.CrossRefGoogle ScholarPubMed
Kenny, D, Berman, D, Zahn, E, Amin, Z. Variable approaches to arterial ductal stenting in infants with complex congenital heart disease. Catheter Cardiovasc Interv 2012; 79: 125–130.CrossRefGoogle ScholarPubMed
Glatz, AC, Petit, CJ, Goldstein, BH, et al. Comparison between patent ductus arteriosus stent and modified Blalock-Taussig shunt as palliation for infants with ductal-dependent pulmonary blood flow: insights from the congenital catheterization research collaborative. Circulation 2018; 137: 589–601.CrossRefGoogle ScholarPubMed
Celebi, A, Yucel, IK, Bulut, MO, Kucuk, M, Balli, S. Stenting of the ductus arteriosus in infants with functionally univentricular heart disease and ductal-dependent pulmonary blood flow: a single-center experience. Catheter Cardiovasc Interv 2017; 89: 699–708.CrossRefGoogle ScholarPubMed
Santoro, G, Capozzi, G, Caianiello, G, et al. Pulmonary artery growth after palliation of congenital heart disease with duct-dependent pulmonary circulation: arterial duct stenting versus surgical shunt. J Am Coll Cardiol 2009; 54: 2180–2186.CrossRefGoogle ScholarPubMed
Alwi, M, Choo, KK, Latiff, HA, Kandavello, G, Samion, H, Mulyadi, MD. Initial results and medium-term follow-up of stent implantation of patent ductus arteriosus in duct-dependent pulmonary circulation. J Am Coll Cardiol 2004; 44: 438–445.CrossRefGoogle ScholarPubMed
Bentham, JR, Zava, KN, Harrison, WJ, et al. Duct stenting versus modified Blalock-Taussig shunt in neonates with duct-dependent pulmonary blood flow: associations with clinical outcomes in a multicenter national study. Circulation 2018; 137: 581–588.CrossRefGoogle Scholar
Schranz, D, Michel-Behnke, I, Heyer, R, et al. Stent implantation of the arterial duct in newborns with a truly duct-dependent pulmonary circulation: a single-center experience with emphasis on aspects of the interventional technique. Interv Cardiol 2010; 23: 581–588.CrossRefGoogle ScholarPubMed
Vida, VL, Speggiorin, S, Maschietto, N, et al. Cardiac operations after patent ductus arteriosus stenting in duct-dependent pulmonary circulation. Ann Thorac Surg 2010; 90: 605–609.CrossRefGoogle ScholarPubMed
Roggen, M, Cools, B, Brown, S, et al. Can ductus arteriosus morphology influence technique/outcome of stent treatment? Catheter Cardiovasc Interv 2020. doi: 10.1002/ccd.28725 [Epub ahead of print].CrossRefGoogle ScholarPubMed
Alwi, M, Mood, MC. Stenting of lesions in patent ductus arteriosus with duct-dependent pulmonary blood flow. Interv Cardiol Clin 2013; 2: 93–113.Google ScholarPubMed
Schranz, D, Michel-Behnke, I. Axillary artery access for cardiac interventions in newborns. Ann Pediatr Card 2008; 1: 126–130.CrossRefGoogle ScholarPubMed