Acute and mid‐term outcomes of stent implantation for recurrent coarctation of the aorta between the Norwood operation and fontan completion: A multi‐center Pediatric Interventional Cardiology Early Career Society Investigation

Aldoss, Osamah; Goldstein, Bryan H.; Danon, Saar; Góreczny, Sebastian; Gray, Robert G.; Sathanandam, Shyam; Whiteside, Wendy; Williams, Derek A.; Zampi, Jeffrey D.

doi:10.1002/ccd.27231

Cited by 10 publications

(3 citation statements)

References 26 publications

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“…This was studied by Aldoss and colleagues, who reviewed outcomes for stent implantation for recurrent coarctation in the Norwood population in 33 patients at 8 centers. (33) The authors report excellent immediate results of both improvement of the aortic diameter and reduction in the coarctation pressure gradient with stenting. Twelve patients (36%) had SAEs.…”

Section: Catheter Versus Surgical Intervention For Chdmentioning

confidence: 96%

Selected 2017 Highlights in Congenital Cardiac Anesthesia

Nasr

Twite

Walker

et al. 2018

Journal of Cardiothoracic and Vascular Anesthesia

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Section: Catheter Versus Surgical Intervention For Chdmentioning

confidence: 96%

Selected 2017 Highlights in Congenital Cardiac Anesthesia

Nasr

Twite

Walker

et al. 2018

Journal of Cardiothoracic and Vascular Anesthesia

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“…Transcatheter treatment of aortic arch obstruction in using balloon angioplasty has been well described but may result in inadequate relief of aortic shape with a non-negligible rate of recurrences. Stent implantation has been shown to provide excellent acute relief of aortic arch obstruction but long-term outcomes of this technique in patients with Fontan are necessary to study ( 26 ).…”

Section: Transcatheter Approaches To Fontan Circulation Basic Lesionsmentioning

confidence: 99%

Transcatheter interventions in patients with a Fontan circulation: Current practice and future developments

et al. 2022

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The Fontan operation represents the last of multiple steps that are offered a wide range of congenital cardiac lesions with a single ventricle (SV) physiology. Nowadays this surgical program consists of a total cavopulmonary connection (TCPC), by anastomosing systemic veins to the pulmonary arteries (PAs), excluding the right-sided circulation from the heart. As a result of imaging, surgical, percutaneous, and critical care improvements, survival in this population has steadily increased. However, the Fontan physiology chronically increases systemic venous pressure causing systemic venous congestion and decreased cardiac output, exposing patients to the failure of the Fontan circulation (FC), which is associated with a wide variety of clinical complications such as liver disease, cyanosis, thromboembolism, protein-losing enteropathy (PLE), plastic bronchitis (PB), and renal dysfunction, ultimately resulting in an increased risk of exercise intolerance, arrhythmias, and premature death. The pathophysiology of the failing Fontan is complex and multifactorial; i.e., caused by the single ventricle dysfunction (diastolic/systolic failure, arrhythmias, AV valve regurgitation, etc.) or caused by the specific circulation (conduits, pulmonary vessels, etc.). The treatment is still challenging and may include multiple options and tools. Among the possible options, today, interventional catheterization is a reliable option, through which different procedures can target various failing elements of the FC. In this review, we aim to provide an overview of indications, techniques, and results of transcatheter options to treat cavopulmonary stenosis, collaterals, impaired lymphatic drainage, and the management of the fenestration, as well as to explore the recent advancements and clinical applications of transcatheter cavopulmonary connections, percutaneous valvular treatments, and to discuss the future perspectives of percutaneous therapies in the Fontan population.

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“…In this issue of Catheterization and Cardiovascular Interventions , Aldoss et al have reported the results of a multi‐center retrospective study of 33 patients aged 4.1–13.3 months, weighing 5.2–8.6 kg, who underwent transcatheter stent implantation for recurrent coarctation in single ventricle patients after the Norwood operation but prior to Fontan completion. Twenty‐nine patients (88%) underwent a prior failed balloon angioplasty before stent implantation (SI).…”

mentioning

confidence: 99%

Recurrent coarctation of aorta after Norwood operation in single ventricle patients; the case of the missing ideal stent

Parekh¹,

Krajcer²

2017

Cathet Cardio Intervent

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Recurrent coarctation postoperative Norwood is poorly tolerated in single ventricle patients. Although transcatheter balloon angioplasty is considered first line, it often leads to inadequate or non-durable relief of obstruction. Transcatheter stent implantation provides excellent relief of obstruction but necessitates staged redilation to account for somatic growth in children. Stent technology, delivery systems, and procedural techniques will need to evolve to obviate reported adverse events mainly due to patient size.

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Acute and mid‐term outcomes of stent implantation for recurrent coarctation of the aorta between the Norwood operation and fontan completion: A multi‐center Pediatric Interventional Cardiology Early Career Society Investigation

Abstract: SI for treatment of RC in patients after the Norwood operation provides excellent acute relief of obstruction. Intraprocedural hemodynamic instability is common and re-intervention is frequent at mid-term follow-up.

Cited by 10 publications

References 26 publications

Selected 2017 Highlights in Congenital Cardiac Anesthesia

Selected 2017 Highlights in Congenital Cardiac Anesthesia

Transcatheter interventions in patients with a Fontan circulation: Current practice and future developments

Recurrent coarctation of aorta after Norwood operation in single ventricle patients; the case of the missing ideal stent

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