Evolution of Approach to Right Ventricular Outflow Tract Stenting in Infants ≤ 2Kgs

Walsh, Kevin; McGuinness, Jonathan; Linnane, Niall; Damien, Kenny

doi:10.12945/j.jshd.2018.045.17

Cited by 4 publications

(1 citation statement)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In patients less than 2 kg we have moved to a hybrid subxiphoid approach, following our experience in the 1.8 kg infant described above. This particular approach provides a direct trajectory to the RVOT, avoiding the tricuspid valve and again obviating the need for a long delivery sheath 12,13 …”

Section: Discussionmentioning

confidence: 99%

Right ventricular outflow tract stenting in symptomatic infants without the use of a long delivery sheath

Linnane

Nasef

McMahon

et al. 2021

Cathet Cardio Intervent

Self Cite

View full text Add to dashboard Cite

Background and Objectives Right ventricular outflow tract (RVOT) stenting improves systemic oxygenation and facilitates pulmonary arterial growth in symptomatic infants prior to repair of tetralogy of Fallot. The aim of this study was to evaluate the safety and efficacy of RVOT stenting without the use of a long delivery sheath. Methods Retrospective data analysis of patients under 1 year of age undergoing RVOT stenting from January 2010 to January 2020 at a single tertiary pediatric cardiology center. Results Sixty‐three RVOT stents were deployed during 53 procedures into 44 patients. The median age and weight at insertion were 41 days (range 2–204) and 3.6 kg (range 1.59–7) respectively. Thirty‐one procedures were semi‐elective and 22 were emergencies. Stent positioning was guided by transthoracic echocardiogram and/or RV angiography from a pigtail micro‐catheter placed via the aorta. The median total procedure and fluoroscopy times were 67.5 (range 15–145) and 19 min (1–107), respectively. The median length of hospital stay was 7 days (range 1–258). Twenty‐one patients were admitted to ICU post‐procedure with a median ICU length of stay of 3 days (range 3–11). There were three major complications including two deaths within 30 days of the procedure. A patient with Cornelia de Lange Syndrome (1.8 kg) died following stent migration and inability to wean from emergency cardiopulmonary bypass and the second infant had an unexplained asystolic arrest post‐procedure while awaiting transfer to ICU. Conclusions RVOT stenting is technically possible with minimal complications without the need for a long delivery sheath. Additional imaging with transthoracic echocardiography can facilitate the safe deployment of the stent.

show abstract

Section: Discussionmentioning

confidence: 99%