OBJECTIVE: To assess the indication, technical aspects, and outcome of stenting of the right ventricular outflow tract (RVOT) in the management of symptomatic patients with severely limited pulmonary blood flow. METHODS: Retrospective case note and procedure review of patients undergoing stenting of the RVOT over an 8 year period. PATIENTS: Between 2005 and 2012, 52 selected patients underwent percutaneous stent implantation into a very narrow RVOT to improve pulmonary blood flow. Median age at stent implantation was 63 (range 4-406) days and median weight was 3.8 (1.7-12.2) kg. RESULTS: 52 patients underwent stent implantation. Median procedure time was 57 (24-260) min and fluoroscopy time 16 (5.5-73) min. There was one procedural death (1.9%) and one emergency surgery (1.9%). Saturations increased from 71% (52-83%) to 92% (81-100%) (p<0.001). Two patients required early shunts due to inadequate palliation and two died from non-cardiac causes. Sixteen further catheter interventions were undertaken (balloon in 7, further stent in 9). Twenty-nine patients underwent delayed surgery (complete repair in 26, palliative in 3) at a median of 172 (52-758) days post-stenting. Left pulmonary artery Z score increased from a pre-interventional value of -1.75 (-4.96 to 0.67) to a pre-surgical value of -0.55 (-4.12 to 1.97), (p<0.01). Median right pulmonary artery Z score increased from -2.63 (-7.70 to 0.89) to -0.75 (-6.69 to 1.18) (p<0.01) . Seventeen patients remain well palliated after a median of 122 (40-286) days. CONCLUSIONS: Stenting of the RVOT is an effective treatment option in the initial management of selected patients with very reduced pulmonary blood flow.
OBJECTIVE: To assess the indication, technical aspects, and outcome of stenting of the right ventricular outflow tract (RVOT) in the management of symptomatic patients with severely limited pulmonary blood flow. METHODS: Retrospective case note and procedure review of patients undergoing stenting of the RVOT over an 8 year period. PATIENTS: Between 2005 and 2012, 52 selected patients underwent percutaneous stent implantation into a very narrow RVOT to improve pulmonary blood flow. Median age at stent implantation was 63 (range 4-406) days and median weight was 3.8 (1.7-12.2) kg. RESULTS: 52 patients underwent stent implantation. Median procedure time was 57 (24-260) min and fluoroscopy time 16 (5.5-73) min. There was one procedural death (1.9%) and one emergency surgery (1.9%). Saturations increased from 71% (52-83%) to 92% (81-100%) (p<0.001). Two patients required early shunts due to inadequate palliation and two died from non-cardiac causes. Sixteen further catheter interventions were undertaken (balloon in 7, further stent in 9). Twenty-nine patients underwent delayed surgery (complete repair in 26, palliative in 3) at a median of 172 (52-758) days post-stenting. Left pulmonary artery Z score increased from a pre-interventional value of -1.75 (-4.96 to 0.67) to a pre-surgical value of -0.55 (-4.12 to 1.97), (p<0.01). Median right pulmonary artery Z score increased from -2.63 (-7.70 to 0.89) to -0.75 (-6.69 to 1.18) (p<0.01) . Seventeen patients remain well palliated after a median of 122 (40-286) days. CONCLUSIONS: Stenting of the RVOT is an effective treatment option in the initial management of selected patients with very reduced pulmonary blood flow.
Authors: İbrahim Cansaran Tanıdır; Mustafa Orhan Bulut; Hacer Kamalı; Erkut Öztürk; İlker Kemal Yücel; Alper Güzeltaş; Türkay Sarıtaş; Abdullah Erdem; Ahmet Çelebi Journal: Turk Gogus Kalp Damar Cerrahisi Derg Date: 2020-07-28 Impact factor: 0.332
Authors: Nigel E Drury; Rehana Bi; Rebecca L Woolley; John Stickley; Kevin P Morris; James Montgomerie; Carin van Doorn; Warwick B Dunn; Melanie Madhani; Natalie J Ives; Paulus Kirchhof; Timothy J Jones Journal: BMJ Open Date: 2020-10-07 Impact factor: 2.692