Shabana Shahanavaz1,2, Athar M Qureshi3, Christopher J Petit4,5, Bryan H Goldstein2,6, Andrew C Glatz7, Holly D Bauser-Heaton4, Courtney E McCracken8, Michael S Kelleman8, Mark A Law9, George T Nicholson10, Jeffrey D Zampi11, Joelle Pettus4, Jeffery Meadows12. 1. Division of Cardiology, Department of Pediatrics, Washington University in St. Louis School of Medicine, MO (S.S.). 2. The Heart Institute, Cincinnati Children's Hospital Medical Center, OH (S.S., B.H.G.). 3. The Lillie Frank Abercrombie Section of Cardiology, Baylor College of Medicine, Texas Children's Hospital, Houston (A.M.Q.). 4. Emory University School of Medicine, Children's Healthcare of Atlanta, GA (C.J.P., H.D.B.-H., J.P.). 5. Division of Pediatric Cardiology, Columbia University Vagelos College of Physicians and Surgeons, New York Presbyterian Hospital (C.J.P.). 6. Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, PA (B.H.G.). 7. Perelman School of Medicine at the University of Pennsylvania, Children's Hospital of Philadelphia (A.C.G.). 8. Department of Pediatrics, Emory University School of Medicine, Atlanta, GA (C.E.M., M.S.K.). 9. Department of Pediatrics, Division of Pediatric Cardiology, University of Alabama at Birmingham (M.A.L.). 10. Division of Pediatric Cardiology, Department of Pediatrics at the Ann and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN (G.T.N.). 11. Department of Pediatrics, Division of Cardiology, University of Michigan, Ann Arbor (J.D.Z.). 12. Division of Pediatric Cardiology, University of California, San Francisco (J.M.).
Abstract
BACKGROUND: Stenting of the patent ductus arteriosus (PDA) is an established palliative option for infants with ductal-dependent pulmonary blood flow. Following initial palliation, reintervention on the PDA stent is common, but risk factors have not been characterized. METHODS: Infants with ductal-dependent pulmonary blood flow palliated with PDA stent between 2008 and 2015 were reviewed within the Congenital Cardiac Research Collaborative. Rates and risk factors for reintervention were analyzed. RESULTS: Among 105 infants who underwent successful PDA stenting, 41 patients (39%) underwent a total of 53 reinterventions on the PDA stent, with all but one occurring within 6 months of the initial intervention. Stent redilation constituted the majority of reintervention (n=35; 66%) followed by additional stent placement (n=11; 21%) and surgical shunt placement (n=7; 13%). The majority of reintervention was nonurgent, and there were no deaths during the reintervention procedure. All but one reintervention occurred within 6 months of the initial procedure. On univariate analysis, risk factors for reintervention included anticipated single-ventricle physiology, lack of prior balloon pulmonary valvuloplasty, use of drug-eluting stent, and increased ductal tortuosity. CONCLUSIONS: In infants with ductal-dependent pulmonary blood flow palliated with PDA stent implantation, reintervention is common, can be performed safely, and is associated with both anatomic/procedural factors and anticipated final physiology.
BACKGROUND: Stenting of the patent ductus arteriosus (PDA) is an established palliative option for infants with ductal-dependent pulmonary blood flow. Following initial palliation, reintervention on the PDA stent is common, but risk factors have not been characterized. METHODS: Infants with ductal-dependent pulmonary blood flow palliated with PDA stent between 2008 and 2015 were reviewed within the Congenital Cardiac Research Collaborative. Rates and risk factors for reintervention were analyzed. RESULTS: Among 105 infants who underwent successful PDA stenting, 41 patients (39%) underwent a total of 53 reinterventions on the PDA stent, with all but one occurring within 6 months of the initial intervention. Stent redilation constituted the majority of reintervention (n=35; 66%) followed by additional stent placement (n=11; 21%) and surgical shunt placement (n=7; 13%). The majority of reintervention was nonurgent, and there were no deaths during the reintervention procedure. All but one reintervention occurred within 6 months of the initial procedure. On univariate analysis, risk factors for reintervention included anticipated single-ventricle physiology, lack of prior balloon pulmonary valvuloplasty, use of drug-eluting stent, and increased ductal tortuosity. CONCLUSIONS: In infants with ductal-dependent pulmonary blood flow palliated with PDA stent implantation, reintervention is common, can be performed safely, and is associated with both anatomic/procedural factors and anticipated final physiology.
Entities:
Keywords:
infant; pulmonary artery; risk factors; stents; tetralogy of Fallot
Authors: Alexandros Rovas; Konrad Buscher; Irina Osiaevi; Carolin Christina Drost; Jan Sackarnd; Phil-Robin Tepasse; Manfred Fobker; Joachim Kühn; Stephan Braune; Ulrich Göbel; Gerold Thölking; Andreas Gröschel; Jan Rossaint; Hans Vink; Alexander Lukasz; Hermann Pavenstädt; Philipp Kümpers Journal: Angiogenesis Date: 2022-06-20 Impact factor: 10.658
Authors: Regina Wespi; Alessia Callegari; Daniel Quandt; Jana Logoteta; Michael von Rhein; Oliver Kretschmar; Walter Knirsch Journal: Int J Environ Res Public Health Date: 2022-10-06 Impact factor: 4.614