Document Detail


The outcome of pulmonary artery stents following surgical manipulation.
MedLine Citation:
PMID:  20549686     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background: Pulmonary artery (PA) stents are utilized to treat branch pulmonary stenosis (BPS). Often patients with PA stents undergo subsequent cardiac surgery for other indications, and the stents can be manipulated during the procedure. Objective: The purpose of this study was to evaluate the outcome of branch PA stenoses following surgical manipulation of previously implanted PA stents and to determine factors associated with future reintervention. Methods: Catheterization data, operative reports, and clinical summaries were reviewed on patients with PA stents placed between September 1989 and December 2006 undergoing subsequent cardiac surgery. Surgical manipulation was recorded as removed, trimmed, or longitudinally transected, and patched. Those that were not manipulated were defined as untouched. Results: 459 patients had branch PA stents placed. About 54 patients, with 70 stents in branch PA's. subsequently had further cardiac surgery. The median age of stent placement was 7.5 (0.5-32.4) years with a median age of surgery of 12.7 (5.1-39.6) years. Surgical manipulation was performed in 23 (33%) PA's and 47 (66%) stents were untouched. Stent removal occurred in 11 (16%), with transecting longitudinally and patching in 5 (7%), and trimming in 7 (10%). Comparing the surgical manipulation and the untouched groups, there was no difference in median age of stent placement [7.2 (0.5-30.2) versus 7.6 (1.8-32.4) years, p = 0.40], wt [21.0 (5.3-86.5) versus 24.7 (9.0-96.0) kg, p = 0.42], or residual catheterization gradient across the stent [3 (0-59) versus 4 (0-50) mmHg, p = 0.81]. Catheter reintervention (stent n = 6 or balloon dilation n = 14) on the previously stented PAs was similar between the surgically manipulated (median 7.5 years) and untouched groups (median 11.5 years) (p = 0.31). In multivariate analysis, the factors associated with future catheter reintervention were having the stent transected longitudinally and patched (p = 0.003) and a lower weight (p = 0.006) at the time of stent placement. Conclusions: Surgical stent manipulation is often performed in patients who have PA stents. Surgical manipulation does not alter the need for future reintervention and catheter re-intervention may be more likely when the stents are transected longitudinally and patched. © 2010 Wiley-Liss, Inc.
Authors:
Mark A Law; John P Breinholt; Pirouz Shamszad; Henri Justino; Charles E Mullins; Frank F Ing
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  77     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  390-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Wiley-Liss, Inc.
Affiliation:
Division of Pediatric Cardiogy, The University of Alabama at Birmingham, Birmingham, Alabama.
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