Percutaneous treatment of ductal origin of the distal pulmonary artery in low-weight newborns.

OBJECTIVE

We sought to evaluate the role of percutaneous techniques in the treatment of ductal origin of a distal pulmonary artery (PA) in low-weight infants.

BACKGROUND

Various surgical approaches have been proposed, however, they are highly challenging and risky in neonates.

METHODS

We treated 5 infants weighing < 3 kg with ductal origin of the PA associated with other congenital heart disease. Procedures were performed under general anesthesia and orotracheal intubation.

RESULTS

A total of 7 coronary stents were used. Median procedure and fluoroscopy times were 100 and 8 minutes, respectively. Oxygen saturation increased significantly in all cases (p = 0.026). Both procedural and postprocedural courses were uneventful and the patients were discharged 7-10 days post procedure. During a follow up of 4-12 months, the results remained stable. Two subjects underwent complete corrective surgery 6 months after stent implantation at a weight of 7-9 kg. Ductus arteriosus with the stent inside were completely removed by surgeons who did not report any difficulty. Three subjects await surgery.

CONCLUSION

Percutaneous management of the ductal origin of the pulmonary artery is a safe and efficacious palliative approach.