OBJECTIVES: This study sought to compare pulmonary arterial (PA) growth during palliation after right ventricular outflow tract (RVOT) stenting versus modified Blalock-Taussig shunt (mBTS) in patients coming forward for complete repair of tetralogy of Fallot-type lesions. BACKGROUND: RVOT stenting is a recent alternative to mBTS in the initial palliation of selected patients with Fallot-type lesions. METHODS: This was a retrospective, single-center study of nonrandomized, consecutive palliated Fallot patients over a 10-year period. Differential left PA (LPA) and right PA (RPA) growth was assessed by serial echocardiograms in 67 patients after mBTS (n = 28) or RVOT stent (n = 39). Statistical data analysis was performed using mixed model analysis. RESULTS: RPA z-scores in the mBTS group improved from median -2.41 (interquartile range [IQR]: -2.97 to -1.32) to -1.13 (IQR: -1.68 to -0.59). LPA z-scores improved from -1.89 (IQR: -2.33 to -1.12) to -0.32 (IQR: -0.88 to -0.05). In the RVOT stenting group RPA z-scores improved from -2.28 (IQR: -3.28 to -1.82) to -0.72 (IQR: -1.27 to +0.48), and LPA z-scores from -2.08 (IQR: -2.90 to -0.61) to -0.05 (IQR: -0.88 to +0.48). Mixed model analysis showed significantly better RPA and LPA growth after RVOT stenting. The benefit of RVOT stenting versus mBTS was 0.599 z-scores for the LPA and 0.749 z-scores for the RPA. Rise in oxygen saturations was greater with RVOT stenting (p = 0.012). Median time to complete repair was shorter in the RVOT stent group (227 [142 to 328] days) compared with the mBTS group (439 [300 to 529] days; p < 0.0003). CONCLUSIONS: RVOT stenting promotes better pulmonary arterial growth and oxygen saturations compared with mBTS in the initial palliation of Fallot-type lesions.
OBJECTIVES: This study sought to compare pulmonary arterial (PA) growth during palliation after right ventricular outflow tract (RVOT) stenting versus modified Blalock-Taussig shunt (mBTS) in patients coming forward for complete repair of tetralogy of Fallot-type lesions. BACKGROUND: RVOT stenting is a recent alternative to mBTS in the initial palliation of selected patients with Fallot-type lesions. METHODS: This was a retrospective, single-center study of nonrandomized, consecutive palliated Fallotpatients over a 10-year period. Differential left PA (LPA) and right PA (RPA) growth was assessed by serial echocardiograms in 67 patients after mBTS (n = 28) or RVOT stent (n = 39). Statistical data analysis was performed using mixed model analysis. RESULTS:RPA z-scores in the mBTS group improved from median -2.41 (interquartile range [IQR]: -2.97 to -1.32) to -1.13 (IQR: -1.68 to -0.59). LPA z-scores improved from -1.89 (IQR: -2.33 to -1.12) to -0.32 (IQR: -0.88 to -0.05). In the RVOT stenting group RPA z-scores improved from -2.28 (IQR: -3.28 to -1.82) to -0.72 (IQR: -1.27 to +0.48), and LPA z-scores from -2.08 (IQR: -2.90 to -0.61) to -0.05 (IQR: -0.88 to +0.48). Mixed model analysis showed significantly better RPA and LPA growth after RVOT stenting. The benefit of RVOT stenting versus mBTS was 0.599 z-scores for the LPA and 0.749 z-scores for the RPA. Rise in oxygen saturations was greater with RVOT stenting (p = 0.012). Median time to complete repair was shorter in the RVOT stent group (227 [142 to 328] days) compared with the mBTS group (439 [300 to 529] days; p < 0.0003). CONCLUSIONS: RVOT stenting promotes better pulmonary arterial growth and oxygen saturations compared with mBTS in the initial palliation of Fallot-type lesions.
Authors: Mark A Law; Andrew C Glatz; Jennifer C Romano; Paul J Chai; Christopher E Mascio; Christopher J Petit; Courtney E McCracken; Michael S Kelleman; George T Nicholson; Jeffery J Meadows; Jeffrey D Zampi; Shabana Shahanavaz; Sarosh P Batlivala; Joelle Pettus; Amy L Pajk; Kristal M Hock; Bryan H Goldstein; Athar M Qureshi Journal: Pediatr Cardiol Date: 2022-04-05 Impact factor: 1.838
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: Bryan H Goldstein; Christopher J Petit; Athar M Qureshi; Courtney E McCracken; Michael S Kelleman; George T Nicholson; Mark A Law; Jeffery J Meadows; Jeffrey D Zampi; Shabana Shahanavaz; Christopher E Mascio; Paul J Chai; Jennifer C Romano; Sarosh P Batlivala; Shiraz A Maskatia; Ivor B Asztalos; Alicia M Kamsheh; Steven J Healan; Justin D Smith; R Allen Ligon; Joelle A Pettus; Sarina Juma; James E B Raulston; Krissie M Hock; Amy L Pajk; Lindsay F Eilers; Hala Q Khan; Taylor C Merritt; Matthew Canter; Stephan Juergensen; Fatuma-Ayaan Rinderknecht; Holly Bauser-Heaton; Andrew C Glatz Journal: J Am Coll Cardiol Date: 2021-03-02 Impact factor: 24.094