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  • Oral presentation
  • Open Access

Right ventricular outflow tract deployment of stents in the management of tetralogy with hypoplastic pulmonary arteries

  • 1Email author,
  • 2,
  • 2,
  • 3,
  • 3,
  • 3,
  • 4 and
  • 5
Journal of Cardiothoracic Surgery20138 (Suppl 1) :O312

https://doi.org/10.1186/1749-8090-8-S1-O312

  • Published:

Keywords

  • Pulmonary Artery
  • Ventricular Outflow Tract
  • Initial Procedure
  • Right Ventricular Outflow Tract
  • Shunt Patient

Objective

Patients with tetralogy or double outlet right ventricle with pulmonary stenosis who present with cyanosis before 4 months of age remain a treatment challenge. Those patients presenting as newborns are especially difficult to manage. We have introduced a coronary stent into the right ventricular outflow tract (RVOT) as an alternative to performing a systemic to pulmonary artery shunt.

Methods

The databases in Minsk and Kemerovo were queried to identify all patients undergoing stent deployment in the RVOT. Additionally all patients less than 4 months of age receiving a systemic to pulmonary shunt for TOF or DORV/PS were identified. A total of 35 patients were identified. The data for those receiving stents was compared to those receiving shunts.

Results

Twelve (12) children received a stent and 23 received shunts. Age (days) and weight (kg) respectively were 59.2 ± 30.9, 3.7 ± 0.9 for stent patients and 64.2 ± 40.9, 3.9 ± 1.3, for shunt patients (p, NS for age and weight). Pre-procedural saturations and pulmonary artery size (mean branch size in mm) were 74.6% ± 13.6, 4.8 ± 1.3 for shunts and 76.7 ± 11.2, 3.9 ± 0.8 for stents (p, NS sats, p = 0.017, size). Secondary procedures were required in 3/12 stent patients and 6/23 shunt patients. Initial procedure mortality was 0/12 (0%) stents and 2/23 (8.7%) shunts. The time interval between initial procedure and complete repair was 17.7 ± 5.2 months for shunt patients and 6.5 ± 4.2 months for stent patients (p < 0.001). Repair type was trans-annular patch or right ventricular pulmonary artery conduit in 89% (16/18) shunt patients and all patients with stents (9/9) had a trans-annular patch. Post repair procedures consisted of coiling collaterals in 2/9 with stents and none with shunts. Survival through complete repair was 100% (9/9) in stents and 85% (17/20) in the shunts.

Conclusion

Stents placed in the RVOT of infants with tetralogy can be performed with low mortality and improve total survival.

Authors’ Affiliations

(1)
Pediatric Cardiac Surgery, Research Institute for Complex Issues of Cardiovascular Diseases, Siberian Branch of the Russian Academy of Medical Sciences, Kemerovo, Russia
(2)
Pediatric Cardiac Surgery, National Children's Cardiac Surgical Center, Minsk, Belarus
(3)
Pediatric Cardiology, National Children's Cardiac Surgical Center, Minsk, Belarus
(4)
Pediatric Cardiology, Research Institute for Complex Issues of Cardiovascular Diseases, Siberian Branch of the Russian Academy of Medical Sciences, Kemerovo, Russia
(5)
Department of Surgery, University of Tennessee Health Sciences Center and International Children's Heart Foundation, Memphis, TN, USA

Copyright

© Nohkrin et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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