Maintaining ductus arteriosus patency by the percutaneous placement of coronary artery stents provides an alternative to surgical systemic-to-pulmonary artery shunts. This maintains pulmonary blood flow and serves as a temporary bridge towards later surgical repair. Since the first report by Gibbs, et al. in 1992, the success and outcome of ductal stenting have improved due to advances in technique and equipment. This is now considered an acceptable option for these patients in many centres.
OUTCOMES OF DUCTUS ARTERIOSUS STENTING: A REVIEW OF CURRENT LITERATURE
Immediate outcomes of PDA stentingA detailed description of the immediate outcomes of PDA stenting can be viewed in Table 1. (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) The majority of patients underwent patent ductus arteriosus (PDA) stenting at an early age, usually shortly after birth, with weights ranging between 1.5 -4.5kg.Procedural success was good and stent placement was successful in 80 to 100% of the cases. The effectiveness of the procedure is highlighted by the fact that all studies have shown a significant improvement in arterial saturations after stent placement. Some cases have required more than 1 stent in an attempt to ensure adequate coverage of the entire ductal length. Reported periprocedural complication rates were low: major complications included stent migration, acute thrombosis and permanent femoral vessel damage. Very few immediate deaths were directly related to
We discuss our experience using the new Cera TM and Ceraflex TM (Lifetech, Nashan, Shenzhen, China) devices in closing PDAs, an ASD and PFOs.
PATIENTSThis is a retrospective review of lesions closed using the Cera
ABSTRACTASD AND PDA CLOSURE
Congenital heart lesions involving the right ventricular outflow tract (RVOT) are a common problem in paediatric cardiology. These patients need multiple surgical interventions in the form of valved conduits over a lifetime. Surgical re-valvulation was the standard treatment option until the introduction of percutaneous pulmonary valves over a decade ago. These valves can be used to prolong the lifespan of conduits and reduce the number of re-operations. The Melody® valve (Medtronic, Minneapolis, MN, USA) was introduced as the first dedicated percutaneous pulmonary valve. Percutaneous pulmonary valves can be implanted successfully and have the advantage of short hospitalisations. We describe the first three Melody® valve implantations in Africa.
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