Abqari Shaad, Kidwai Mohammad Moaaz, Kamran Mirza Mohammad, Haseen Mohammad Azam, Rabbani Shamayal
Department of Pediatrics, JNMCH, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
Department of Cardiology, JNMCH, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
Cardiol Young. 2025 Feb;35(2):393-398. doi: 10.1017/S1047951124036527. Epub 2024 Dec 26.
Right ventricular outflow tract stenting has emerged as a key palliative intervention for infants with tetralogy of Fallot who are not suitable candidates for complete repair. Although the Blalock-Taussig shunt remains the standard palliative approach for tetralogy of Fallot patients over one year of age, the potential of right ventricular outflow tract stenting in this older age group has not been widely explored. In this study, we present our experience with right ventricular outflow tract stenting in children beyond one year of age.
In this study, a total of 52 patients of tetralogy of Fallot who underwent palliative stenting of the right ventricular outflow tract from 2018 to 2022 were enrolled. Out of the 52 patients, 38 children were more than 1 year of age with a mean age of 4.82 ± 3.5 (1.5-13 years) and mean weight of 13.10 ± 7.0 (5.6-34) kgs. Most common indication was presence of unfavourable anatomy in 27 (71%) followed by presence of refractory spells in 14 (36.8%) patients. Stent embolisation was seen in one patient, while two patients developed features of pulmonary oedema and needed prolonged ventilatory support. There was no mortality seen in this study group.
Our study has shown that right ventricular outflow tract stenting in children even beyond one year of age is technically feasible, with good immediate outcomes, especially in those who present with any complication, thus reducing the perioperative morbidity and mortality.
对于不适合进行根治性修复的法洛四联症婴儿，右心室流出道支架置入术已成为一种关键的姑息性干预措施。尽管布莱洛克-陶西格分流术仍是一岁以上法洛四联症患者的标准姑息治疗方法，但右心室流出道支架置入术在这个年龄较大的群体中的潜力尚未得到广泛探索。在本研究中，我们介绍了我们在一岁以上儿童中进行右心室流出道支架置入术的经验。
本研究纳入了2018年至2022年期间接受右心室流出道姑息性支架置入术的52例法洛四联症患者。在这52例患者中，38例儿童年龄超过1岁，平均年龄为4.82±3.5（1.5 - 13岁），平均体重为13.10±7.0（5.6 - 34）千克。最常见的适应证是27例（71%）存在不利的解剖结构，其次是14例（36.8%）患者存在难治性发作。1例患者出现支架栓塞，2例患者出现肺水肿特征，需要延长通气支持。该研究组无死亡病例。
我们的研究表明，即使是一岁以上儿童的右心室流出道支架置入术在技术上也是可行的，具有良好的即刻效果，尤其是对于那些出现任何并发症的患者，从而降低了围手术期的发病率和死亡率。
