Valeo Stent Use for Ductal-Dependent Systemic Circulations.

Our aim is to describe the experience of ductal stenting using the balloon-expandable Valeo stent in ductal-dependent systemic circulation. Outcomes assessed were procedural success, procedural survival, stent related complications, and re-intervention rates. Hybrid palliation, consisting of ductal stenting and bilateral pulmonary artery band placement, is a widely accepted alternative for stage I palliative surgery. Off-label use of stents is the norm for this procedure. The Valeo stent is one such example with minimal data on its use for ductal stenting. Retrospective data was collected for seventeen patients who underwent the hybrid procedure with ductus arteriosus stenting and pulmonary artery banding between November 2019 and September 2024. Descriptive statistics were performed. Seventeen patients underwent the hybrid procedure between November 2019 and September 2024 with a median age of 14 days (IQR 10-20 days) and median weight of 3.47 kg (IQR 3.2-4.2 kg). Fifteen patients had a single stent implanted at the time of the initial procedure and two patients required an additional stent. There were no intraoperative deaths, there was one in-hospital death. The interstage mortality was 30%, 12 out of 17 patients survived to subsequent planned procedure. The median duration to subsequent palliation was 157 days, during which no patients developed any in-stent stenosis or stent migration. The re-intervention rate was 35%. This consisted of 5 patients that required additional stents in the inter-stage period to address the ductal constriction in the pulmonary or aortic end and 1 patient that required balloon angioplasty for somatic growth. The Valeo stent can be a suitable option for ductal stenting during hybrid procedure in patients with hypoplastic left heart syndrome and other left heart obstructive lesions. It is an effective stent for maintaining ductal patency with good safety profile and a low rate of in-stent stenosis due to intimal proliferation during the inter-stage period.