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Erschienen in: Pediatric Cardiology 1/2013

01.01.2013 | Original Article

Medium and Long-Term Outcomes After Bilateral Pulmonary Artery Stenting in Children and Adults With Congenital Heart Disease

verfasst von: Ismael Gonzalez, Damien Kenny, Shari Slyder, Ziyad M. Hijazi

Erschienen in: Pediatric Cardiology | Ausgabe 1/2013

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Abstract

Percutaneous stenting of branch pulmonary arteries (PAs) has become an important interventional therapy in the complete management of congenital heart disease. Few data exist on long-term outcomes for patients requiring placement of bilateral stents. This study aimed to determine the medium- to long-term outcomes after bilateral stenting of branch PAs in patients with congenital heart disease. A retrospective study analyzed all procedural and follow-up data on patients undergoing bilateral PA stenting during a single procedure. From October 2001 to May 2012, 26 patients underwent bilateral PA stenting (total of 62 stents). The mean age of these patients was 9.5 ± 12 years, and their mean weight was 27 ± 19 kg. The mean procedural time was 191 ± 67 min, and the mean fluoroscopy time was 50 ± 29 min. The mean gradient across the right pulmonary artery decreased from 35 ± 22 to 11 ± 12 mmHg (p < 0.001). The left pulmonary artery gradient decreased from 32 ± 17 to 10 ± 12 mmHg (p < 0.001), and the right ventricle to descending aorta pressure ratio decreased from 71 ± 18 % to 46 ± 13 % (p < 0.001). Intraprocedural adverse events were encountered in four patients (1 small PA dissection, 2 intraprocedural arrhythmias, and 1 first-degree burn on the thigh). The mean follow-up period was 41 ± 23 months. Two deaths occurred. Further interventions were required for 12 patients. Bilateral PA stenting is effective and safe, with an instantaneous significant decrease in pressure gradients. The need for reintervention is common, so continued follow-up assessment is warranted.
Literatur
1.
Zurück zum Zitat Baerlocher L, Kretschmar O, Harpes P (2008) Stent implantation and balloon angioplasty for treatment of branch pulmonary artery stenosis in children. Clin Res Cardiol 97:310–317PubMedCrossRef Baerlocher L, Kretschmar O, Harpes P (2008) Stent implantation and balloon angioplasty for treatment of branch pulmonary artery stenosis in children. Clin Res Cardiol 97:310–317PubMedCrossRef
2.
Zurück zum Zitat Breinholt JP, Nugent AW, Law MA et al (2008) Stent fractures in congenital heart disease. Cathet Cardiovasc Interv 72:977–982CrossRef Breinholt JP, Nugent AW, Law MA et al (2008) Stent fractures in congenital heart disease. Cathet Cardiovasc Interv 72:977–982CrossRef
3.
Zurück zum Zitat Chakrabarti S, Kenny D, Morgan G et al (2010) Balloon expandable stent implantation for native and recurrent coarctation of the aorta-prospective computed tomography assessment of stent integrity, aneurysm formation, and stenosis relief. Heart 96:1212–1216PubMedCrossRef Chakrabarti S, Kenny D, Morgan G et al (2010) Balloon expandable stent implantation for native and recurrent coarctation of the aorta-prospective computed tomography assessment of stent integrity, aneurysm formation, and stenosis relief. Heart 96:1212–1216PubMedCrossRef
4.
Zurück zum Zitat Duke C, Rosenthal E, Qureshi SA (2003) The efficacy and safety of stent redilatation in congenital heart disease. Heart 89:905–912PubMedCrossRef Duke C, Rosenthal E, Qureshi SA (2003) The efficacy and safety of stent redilatation in congenital heart disease. Heart 89:905–912PubMedCrossRef
5.
Zurück zum Zitat Forbes TJ, Rodriguez-Cruz E, Amin Z et al (2003) The Genesis stent: a new low-profile stent for use in infants, children, and adults with congenital heart disease. Cathet Cardiovasc Interv 59:406–414CrossRef Forbes TJ, Rodriguez-Cruz E, Amin Z et al (2003) The Genesis stent: a new low-profile stent for use in infants, children, and adults with congenital heart disease. Cathet Cardiovasc Interv 59:406–414CrossRef
6.
Zurück zum Zitat Guérin P, Rondeau F, Grimandi G et al (2004) Neointimal hyperplasia after stenting in a human mammary artery organ culture. J Vasc Res 41:46–53PubMedCrossRef Guérin P, Rondeau F, Grimandi G et al (2004) Neointimal hyperplasia after stenting in a human mammary artery organ culture. J Vasc Res 41:46–53PubMedCrossRef
7.
Zurück zum Zitat Hijazi ZM, al-Fadley F, Geggel RL et al (1996) Stent implantation for relief of pulmonary artery stenosis: immediate and short-term results. Cathet Cardiovasc Diagn 38:16–23PubMedCrossRef Hijazi ZM, al-Fadley F, Geggel RL et al (1996) Stent implantation for relief of pulmonary artery stenosis: immediate and short-term results. Cathet Cardiovasc Diagn 38:16–23PubMedCrossRef
8.
Zurück zum Zitat Holzer RJ, Gauvreau K, Kreutzer J et al (2011) Balloon angioplasty and stenting of branch pulmonary arteries: adverse events and procedural characteristics: results of a multi-institutional registry. Circ Cardiovasc Interv 4:287–296PubMedCrossRef Holzer RJ, Gauvreau K, Kreutzer J et al (2011) Balloon angioplasty and stenting of branch pulmonary arteries: adverse events and procedural characteristics: results of a multi-institutional registry. Circ Cardiovasc Interv 4:287–296PubMedCrossRef
9.
Zurück zum Zitat Kenny D, Amin Z, Slyder S, Hijazi ZM (2011) Medium-term outcomes for peripheral pulmonary artery stenting in adults with congenital heart disease. J Interv Cardiol 24:373–377PubMedCrossRef Kenny D, Amin Z, Slyder S, Hijazi ZM (2011) Medium-term outcomes for peripheral pulmonary artery stenting in adults with congenital heart disease. J Interv Cardiol 24:373–377PubMedCrossRef
10.
Zurück zum Zitat Kreutzer J, Rome JJ (2002) Open-cell design stents in congenital heart disease: a comparison of IntraStent vs Palmaz stents. Cathet Cardiovasc Interv 56:400–409CrossRef Kreutzer J, Rome JJ (2002) Open-cell design stents in congenital heart disease: a comparison of IntraStent vs Palmaz stents. Cathet Cardiovasc Interv 56:400–409CrossRef
11.
Zurück zum Zitat Law MA, Shamszad P, Nugent AW et al (2010) Pulmonary artery stents: long-term follow-up. Cathet Cardiovasc Interv 75:757–764CrossRef Law MA, Shamszad P, Nugent AW et al (2010) Pulmonary artery stents: long-term follow-up. Cathet Cardiovasc Interv 75:757–764CrossRef
12.
Zurück zum Zitat Law MA, Breinholt JP III, Shamszad P et al (2011) The outcome of pulmonary artery stents following surgical manipulation. Cathet Cardiovasc Interv 77:390–394CrossRef Law MA, Breinholt JP III, Shamszad P et al (2011) The outcome of pulmonary artery stents following surgical manipulation. Cathet Cardiovasc Interv 77:390–394CrossRef
13.
Zurück zum Zitat Maglione J, Bergersen L, Lock JE et al (2009) Ultra-high-pressure balloon angioplasty for treatment of resistant stenoses within or adjacent to previously implanted pulmonary arterial stents. Circ Cardiovasc Interv 2:52–58PubMedCrossRef Maglione J, Bergersen L, Lock JE et al (2009) Ultra-high-pressure balloon angioplasty for treatment of resistant stenoses within or adjacent to previously implanted pulmonary arterial stents. Circ Cardiovasc Interv 2:52–58PubMedCrossRef
14.
Zurück zum Zitat McMahon CJ, El-Said HG, Grifka RG et al (2001) Redilation of endovascular stents in congenital heart disease: factors implicated in the development of restenosis and neointimal proliferation. J Am Coll Cardiol 38:521–526PubMedCrossRef McMahon CJ, El-Said HG, Grifka RG et al (2001) Redilation of endovascular stents in congenital heart disease: factors implicated in the development of restenosis and neointimal proliferation. J Am Coll Cardiol 38:521–526PubMedCrossRef
15.
Zurück zum Zitat McMahon CJ, El Said HG, Vincent JA et al (2002) Refinements in the implantation of pulmonary arterial stents: impact on morbidity and mortality of the procedure over the last two decades. Cardiol Young 12:445–452PubMedCrossRef McMahon CJ, El Said HG, Vincent JA et al (2002) Refinements in the implantation of pulmonary arterial stents: impact on morbidity and mortality of the procedure over the last two decades. Cardiol Young 12:445–452PubMedCrossRef
16.
Zurück zum Zitat Moszura T, Michalak KW, Dryzek P et al (2010) One center experience in pulmonary artery stenting without long vascular sheath. Cardiol J 17:149–156PubMed Moszura T, Michalak KW, Dryzek P et al (2010) One center experience in pulmonary artery stenting without long vascular sheath. Cardiol J 17:149–156PubMed
17.
Zurück zum Zitat O’Laughlin MP (1998) Catheterization treatment of stenosis and hypoplasia of pulmonary arteries. Pediatr Cardiol 19:48–56PubMedCrossRef O’Laughlin MP (1998) Catheterization treatment of stenosis and hypoplasia of pulmonary arteries. Pediatr Cardiol 19:48–56PubMedCrossRef
18.
Zurück zum Zitat Pass RH, Hsu DT, Garabedian CP et al (2002) Endovascular stent implantation in the pulmonary arteries of infants and children without the use of a long vascular sheath. Cathet Cardiovasc Interv 55:505–509CrossRef Pass RH, Hsu DT, Garabedian CP et al (2002) Endovascular stent implantation in the pulmonary arteries of infants and children without the use of a long vascular sheath. Cathet Cardiovasc Interv 55:505–509CrossRef
19.
Zurück zum Zitat Shaffer KM, Mullins CE, Grifka RG et al (1998) Intravascular stents in congenital heart disease: short- and long-term results from a large single-center experience. J Am Coll Cardiol 31:661–667PubMedCrossRef Shaffer KM, Mullins CE, Grifka RG et al (1998) Intravascular stents in congenital heart disease: short- and long-term results from a large single-center experience. J Am Coll Cardiol 31:661–667PubMedCrossRef
20.
Zurück zum Zitat Stanfill R, Nykanen DG, Osorio S et al (2008) Stent implantation is effective treatment of vascular stenosis in young infants with congenital heart disease: acute implantation and long-term follow-up results. Cathet Cardiovasc Interv 71:831–841CrossRef Stanfill R, Nykanen DG, Osorio S et al (2008) Stent implantation is effective treatment of vascular stenosis in young infants with congenital heart disease: acute implantation and long-term follow-up results. Cathet Cardiovasc Interv 71:831–841CrossRef
21.
Zurück zum Zitat Stapleton GE, Hamzeh R, Mullins CE et al (2009) Simultaneous stent implantation to treat bifurcation stenoses in the pulmonary arteries: initial results and long-term follow up. Cathet Cardiovasc Interv 73:557–563CrossRef Stapleton GE, Hamzeh R, Mullins CE et al (2009) Simultaneous stent implantation to treat bifurcation stenoses in the pulmonary arteries: initial results and long-term follow up. Cathet Cardiovasc Interv 73:557–563CrossRef
Metadaten
Titel
Medium and Long-Term Outcomes After Bilateral Pulmonary Artery Stenting in Children and Adults With Congenital Heart Disease
verfasst von
Ismael Gonzalez
Damien Kenny
Shari Slyder
Ziyad M. Hijazi
Publikationsdatum
01.01.2013
Verlag
Springer-Verlag
Erschienen in
Pediatric Cardiology / Ausgabe 1/2013
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-012-0439-9

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