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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: mehmetakifonalan@gmail.com
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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
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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