Document Detail


Arterial duct stenting: Do we still need surgical shunt in congenital heart malformations with duct-dependent pulmonary circulation?
MedLine Citation:
PMID:  20442671     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Despite current trends toward primary repair, surgical systemic-to-pulmonary shunt is still an invaluable palliative option in some patients with congenital heart defects and duct-dependent pulmonary circulation. However, arterial duct stabilization with a high-flexibility coronary stent could be an effective alternative in high-risk surgical candidates or whenever short-term pulmonary blood flow support is anticipated.
METHODS AND RESULTS: On the basis of ductal origin and morphology, the stenting procedure can be performed from an arterial or venous route. Following arterial duct angiographic imaging, the stabilizing stent is chosen to completely cover the entire ductal length and dilated slightly less than the proposed surgical shunt. Procedural failure depends mainly on ductal tortuosity and ranges around 10% of cases. Morbidity and mortality are 8-11% and less than 1%, respectively. Mid-term fate of the stented duct is spontaneous, slow and progressive closure within a few months. Compared with a Blalock-Taussig shunt, stented ducts result in similar but more uniform pulmonary artery growth over a mid-term follow-up.
CONCLUSION: Arterial duct stenting is a technically feasible, well tolerated and effective palliation in congenital heart disease with duct-dependent pulmonary circulation. It is advisable either in high-risk neonates or whenever a short-term pulmonary blood flow support is anticipated. The stented duct appears less durable than a conventional surgical shunt although it is highly effective in promoting a global and uniform pulmonary artery growth.
Authors:
Giuseppe Santoro; Gianpiero Gaio; Maria Teresa Palladino; Biagio Castaldi; Carola Iacono; Raffaella Esposito; Giovanbattista Capozzi; Alessandra Rea; Maria Giovanna Russo; Raffaele Calabrò
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  11     ISSN:  1558-2035     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-09-30     Completed Date:  2011-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  852-7     Citation Subset:  IM    
Affiliation:
Division of Cardiology, 2nd University of Naples, 'Monaldi' Hospital, Naples, Italy. santoropino@tin.it
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Balloon Dilation
Blalock-Taussig Procedure* / adverse effects,  mortality
Ductus Arteriosus, Patent / mortality,  physiopathology,  surgery,  therapy*
Heart Catheterization / adverse effects,  instrumentation*,  mortality
Heart Defects, Congenital / mortality,  physiopathology,  surgery,  therapy*
Humans
Palliative Care
Patient Selection
Pulmonary Circulation*
Stents*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Spontaneous coronary dissection as cause of recurring myocardial infarction.
Next Document:  Ethnic differences in blood pressure in young men living in similar environment: a study of internat...