Bilateral ductal stenting in a neonate with right isolated pulmonary artery of ductal origin and differential pulmonary vascular resistances

Miranda, Carlos D.; Kenny, Damien

doi:10.1002/ccd.26282

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…Several authors have used the terms “isolated PA of ductal origin” or “unilateral ductal origin of a PA” to more accurately describe this condition. Strategies to rehabilitate the isolated PA have been reported 12, 13, 14, 15, 16, 17…”

Section: Conditions In Which Segmental Ph May Developmentioning

confidence: 99%

Definition and Management of Segmental Pulmonary Hypertension

Dimopoulos

Diller

Opotowsky

et al. 2018

JAHA

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Section: Conditions In Which Segmental Ph May Developmentioning

confidence: 99%

Definition and Management of Segmental Pulmonary Hypertension

Dimopoulos

Diller

Opotowsky

et al. 2018

JAHA

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“…Bilateral PDA stenting has been reported previously, most often a prelude to a later biventricular repair [8,9]. One case reported by Kobayashi et al with a similar background died before reaching the Glenn stage [10].…”

Section: Discussionmentioning

confidence: 95%

Catheterization and surgical collaboration in the treatment of complex congenital heart disease with discontinuous pulmonary arteries.

Datta¹,

Breinholt²

2018

invasive-cardiology

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A term, male neonate presents with pulmonary atresia, discontinuous branch pulmonary arteries (PA) arising from independent ducti arteriosus, and dextrocardia presents a challenging treatment plan. The right pulmonary artery (RPA) arose from the ascending aorta while the left pulmonary artery (LPA) arose from the left subclavian artery, with the proximal segments of each spaced about 1 cm apart, making primary unifocalization suboptimal. The cardiac anatomy included: dextrocardia with situs inversus, double outlet right ventricle (DORV) with malposed great arteries and pulmonary atresia, left sided inferior and superior venae cava, and a right aortic arch with mirror image branching. The neonate underwent cardiac catheterization on day of life 12 wherein the bilateral patent ducti arteriosus (PDA) were stented as an alternative to high-risk surgery. In addition, the pulsatile flow via the stents provided a stimulus for PA growth, facilitating transcatheter rehabilitation of distal PA hypoplasia, and optimizing later PA reconstruction. The patient underwent surgery at 13 months of age, with autologous tube creation to unifocalize the Pas and enable the Glenn procedure. Postoperative autograft stenosis was later managed via cardiac catheterization. This report describes the clinical management and utility of staged percutaneous intervention for complex anatomy.

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Contralateral Pulmonary Hypertension Following Resuscitation of Unilateral Ductal Origin of a Pulmonary Artery: A Multi-institutional Review

et al. 2017

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In isolated unilateral ductal origin of a pulmonary artery (DOPA), intervention to establish reperfusion of the affected lung without direct re-anastomosis may lead to pulmonary hypertension (PH) in the contralateral lung. Multicenter retrospective review of patients with unilateral DOPA, who underwent palliation with a ductal stent (DS) or Blalock-Taussig (BT) shunt with subsequent development of PH in the contralateral lung, was conducted. Ten patients (4 females; median weight 3.2 kg, range 2.1-5.2) who underwent DS or BT shunt and developed contralateral PH were identified. Eight infants had right-sided DOPA. Stents/shunt used had a median diameter of 3.5 mm (range 2.5-5.2). After DS in 9 patients, 7 patients were exclusively treated with medical therapies, whereas 2 patients received intermediate procedures: one received an additional contralateral DS and other underwent surgical banding of the DS prior to PA reimplantation. Seven patients who underwent DS and one patient with BT shunt underwent PA reimplantation at median of 3.3 (0.6-18) months. PA pressure was documented to be normal in 5 patients immediately following PA reimplantation, 1 year later in 2 patients, and 1 patient is on Tadalafil with elevated PVR of 5.5 indexed Wood units. One patient died and one patient is awaiting surgery with normal PA pressure. We describe the development of severe contralateral PH following DS or BT shunt as the initial intervention for unilateral DOPA. Pulmonary hypertension resolved in 7/8 patients who underwent surgical PA reimplantation. The cause of PH in the normally connected lung in these cases remains unclear.

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Bilateral ductal stenting in a neonate with right isolated pulmonary artery of ductal origin and differential pulmonary vascular resistances

Cited by 3 publications

References 14 publications

Definition and Management of Segmental Pulmonary Hypertension

Definition and Management of Segmental Pulmonary Hypertension

Catheterization and surgical collaboration in the treatment of complex congenital heart disease with discontinuous pulmonary arteries.

Contralateral Pulmonary Hypertension Following Resuscitation of Unilateral Ductal Origin of a Pulmonary Artery: A Multi-institutional Review

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