Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jul 7;1(6):100392.
doi: 10.1016/j.jscai.2022.100392. eCollection 2022 Nov-Dec.

Stenting of the Patent Ductus Arteriosus: A Meta-analysis and Literature Review

Holly Bauser-Heaton  1 , Katherine Price  2 , Rachel Weber  3 , Howaida El-Said  3
Affiliations
Review

Stenting of the Patent Ductus Arteriosus: A Meta-analysis and Literature Review

Holly Bauser-Heaton et al. J Soc Cardiovasc Angiogr Interv. .

Abstract

Background: Patent ductus arteriosus (PDA) stent placement and systemic-pulmonary surgical shunt procedure can both be performed as palliation for infants with duct-dependent pulmonary circulation. The aim of this meta-analysis and literature review was to compare outcomes and study populations between the 2 methods as well as review the technical considerations and complications of PDA stenting.

Methods: A systematic search was conducted using the PubMed database and meta-analysis was performed. Risk ratio and mean difference were used to compare the reported outcomes of studies across patients receiving PDA stent and surgical shunt.

Results: In total, 1094 patients from 8 comparative observational studies were included. The PDA stent group had a lower mortality rate and a shorter hospital length of stay than the systemic-pulmonary surgical shunt group, although at the expense of increased reintervention rates. There were higher proportions of patients with single-ventricle physiology and single-source pulmonary blood flow in the surgical shunt group.

Conclusions: PDA stenting appears to be a noninferior or possibly superior method of palliation for duct-dependent pulmonary circulation compared with systemic-pulmonary surgical shunt, recognizing, however, that patients receiving surgical shunt more often had single-ventricle physiology or single-source pulmonary blood flow in this meta-analysis.

Keywords: congenital heart disease; duct-dependent pulmonary circulation; palliation; patent ductus arteriosus; shunt; stent.

PubMed Disclaimer

Figures

None
Graphical abstract
Figure 1
Figure 1
Flow diagram of study selection. Of 181 screened articles, 8 articles were ultimately included in the meta-analysis.
Central Illustration
Central Illustration
Forestplot of total mortality. Pooled estimates favor the patent ductus arteriosus stent group.
Figure 2
Figure 2
Forest plot of total reintervention. Each “event” represents a reintervention. Pooled estimates favor the shunt group (more freedom from reintervention in the shunt group).
Figure 3
Figure 3
Forest plot of reintervention directly related to the stent or shunt. Each “event” represents a reintervention. Pooled estimates favor the shunt group (more freedom from reintervention in the shunt group).
Figure 4
Figure 4
Forest plot of hospital length of stay. Pooled estimates favored the patent ductus arteriosus stent group.
Figure 5
Figure 5
Hospital length of stay showing trend toward shorter length of stay for the patent ductus arteriosus stent group (weighted average of all studies).
Figure 6
Figure 6
Proportions of patients with single-ventricle physiology and single-source pulmonary blood flow in the patent ductus arteriosus stent and surgical shunt groups, showing higher proportions in the shunt group. PBF, pulmonary blood flow.
Figure 7
Figure 7
Weighted average change in the Nakata index in patients with stent versus shunt in available studies. PA, pulmonary artery.
Figure 8
Figure 8
Analysis of complication data favoring stent in total comparison.
See this image and copyright information in PMC

References

    1. Moore J.W., Kirby W.C., Lovett E.J., O’Neill J.T. Use of an intravascular endoprosthesis (stent) to establish and maintain short-term patency of the ductus arteriosus in newborn lambs. Cardiovasc Intervent Radiol. 1991;14(5):299–301. - PubMed
    1. Gibbs J.L., Wren C., Watterson K.G., Hunter S., Hamilton J.R. Stenting of the arterial duct combined with banding of the pulmonary arteries and atrial septectomy or septostomy: a new approach to palliation for the hypoplastic left heart syndrome. Br Heart J. 1993;69(6):551–555. - PMC - PubMed
    1. Gibbs J.L., Rothman M.T., Rees M.R., Parsons J.M., Blackburn M.E., Ruiz C.E. Stenting of the arterial duct: a new approach to palliation for pulmonary atresia. Br Heart J. 1992;67(3):240–245. - PMC - PubMed
    1. Ruiz C.E., Zhang H.P., Larsen R.L. The role of interventional cardiology in pediatric heart transplantation. J Heart Lung Transplant. 1993;12(6 Pt 2):S164–S167. - PubMed
    1. Alwi M., Choo K.K., Latiff H.A., Kandavello G., Samion H., Mulyadi M.D. Initial results and medium-term follow-up of stent implantation of patent ductus arteriosus in duct-dependent pulmonary circulation. J Am Coll Cardiol. 2004;44(2):438–445. - PubMed

LinkOut - more resources