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Comparative Study
. 2020 May 1;95(6):1149-1157.
doi: 10.1002/ccd.28725. Epub 2020 Jan 17.

Can ductus arteriosus morphology influence technique/outcome of stent treatment?

Mieke Roggen  1 , Bjorn Cools  1 , Stephen Brown  1   2 , Derize Boshoff  1 , Ruth Heying  1 , Benedicte Eyskens  1 , Marc Gewillig  1
Affiliations
Comparative Study

Can ductus arteriosus morphology influence technique/outcome of stent treatment?

Mieke Roggen et al. Catheter Cardiovasc Interv. .

Abstract

Introduction: Results and outcomes of ductus arteriosus stenting vary widely. The aim of this study was to determine whether ductus morphology is associated with different procedural outcome.

Methods: Over an 18-year period, 123 patients presented with ductal dependent pulmonary blood flow. Results were retrospectively assessed based on radiographic anatomic features of the ductus arteriosus: Group 1: "straight" ductus arteriosus, typically seen in patients with Pulmonary atresia with intact septum (PA-IVS), Group 2: "intermediate" ductus arteriosus as seen in severe pulmonary stenosis (PS)-single ventricle, Group 3: "vertical" ductus arteriosus typically seen in patients with pulmonary atresia-ventricular septal defect, Group 4: ductus arteriosus arising from the aorta to a single lung, Group 5: ductus arteriosus arising from the innominate/subclavian artery to a single lung, Group 6: ductus arteriosus from innominate/subclavian artery to both lungs.

Results: Ductal stenting (DS) was attempted in 98 patients with 99 ducts. Successful stenting was possible in 83 patients. Success of DS was significantly different among the groups (p = .04, F = 5.41). Groups 1, 4, and 5 were "easy" with good success while Groups 2, 3, and 6 were complex and demanding. There were two deaths (after 5 and 7 days, respectively) that could be ascribed to DS. Elective re-interventions were performed in 34 ductuses (40%). Fifty three percent (n = 44/83) of successful ductus stents proceeded to further surgery and 20 ducts closed spontaneously in asymptomatic patients over time.

Conclusions: Ductus arteriosus morphology influences technique and determines complexity, safety, and final outcome of ductus arteriosus stenting.

Keywords: congenital heart disease; cyanosis; ductus arteriosus; ductus arteriosus stent; newborn.

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References

REFERENCES

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