Haddad Raymond N, Hanna Najib, Charbel Ramy, Daou Linda, Chehab Ghassan, Saliba Zakhia
Department of Pediatrics, Hotel-Dieu de France University Medical Center,Saint Joseph University, Alfred Naccache Boulevard, Achrafieh, Beirut,Lebanon.
Department of Pediatric Cardiology, Hotel-Dieu de France University Medical Center,Saint Joseph University,Alfred Naccache Boulevard, Achrafieh, Beirut,Lebanon.
Cardiol Young. 2019 Apr;29(4):492-498. doi: 10.1017/S1047951119000118. Epub 2019 Apr 29.
To assess the feasibility, safety, and efficiency of ductal stenting in pulmonary atresia with intact ventricular septum or critical pulmonary stenosis after balloon pulmonary valvuloplasty.
Ductal stenting in pulmonary atresia with intact ventricular septum is a re-emerging and promising technique. There is little data available on its outcomes after establishing prograde pulmonary blood flow.
We retrospectively reviewed all neonates with pulmonary atresia with intact ventricular septum or critical pulmonary stenosis who underwent ductal stenting after balloon valvuloplasty. Ductal stenting was performed either in the same setting (group A) or a few days later after balloon valvuloplasty (group B). We compared the two groups.
Eighteen coronary stents were transvenously delivered and successfully deployed in 18 newborns. There was no procedure-related mortality. The median hospital stay post-intervention was 6 days with a mean discharge oxygen saturation of 94%. Group A had a shorter overall hospital stay with a shorter overall time of irradiation but with a longer overall procedural time. On a follow-up of 18 months, no re-intervention for stent failure or overflow was undertaken. The median stent patency based on echocardiography was 12 months.
Stenting the arterial duct in pulmonary atresia with intact ventricular septum or critical pulmonary stenosis is a feasible, safe, and efficient technique. It avoids surgery or long hospital stay with prostaglandin infusion. The minimal 6 months stent longevity provides a period of time long enough to decide whether the right ventricular diastolic function is normalised or Glenn surgery is still needed.
评估在室间隔完整的肺动脉闭锁或球囊肺动脉瓣成形术后严重肺动脉狭窄患者中进行动脉导管支架置入术的可行性、安全性和有效性。
在室间隔完整的肺动脉闭锁患者中进行动脉导管支架置入术是一项重新兴起且有前景的技术。关于建立正向肺血流后其结果的数据很少。
我们回顾性分析了所有在球囊瓣膜成形术后接受动脉导管支架置入术的室间隔完整的肺动脉闭锁或严重肺动脉狭窄的新生儿。动脉导管支架置入术在同一时间进行（A组）或在球囊瓣膜成形术后几天进行（B组）。我们对两组进行了比较。
18个冠状动脉支架经静脉输送并成功植入18例新生儿体内。无手术相关死亡。干预后中位住院时间为6天，出院时平均血氧饱和度为94%。A组总体住院时间较短，总照射时间较短，但总体手术时间较长。在18个月的随访中，未因支架故障或血流过度而进行再次干预。基于超声心动图的支架中位通畅时间为12个月。
在室间隔完整的肺动脉闭锁或严重肺动脉狭窄患者中对动脉导管进行支架置入术是一种可行、安全且有效的技术。它避免了手术或因输注前列腺素而长期住院。至少6个月的支架使用寿命提供了足够长的时间来决定右心室舒张功能是否恢复正常或是否仍需要进行格林手术。
