Stenting in Congenital Heart Disease

Tomita, Hideshi; Nakanishi, Toshio; Hamaoka, Kenji; Kobayashi, Toshiki; Ono, Yasuo

doi:10.1253/circj.cj-10-0157

Cited by 27 publications

(12 citation statements)

References 20 publications

(5 reference statements)

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“…Presently, there was no instance of mortality and the rate of complications association with implantation was 12%, similar to the long-term reports of other studies 9)13)14)16)17). One study reported their long term result of pulmonary stent experiencing 9.1% of complication rate (six out of 55 stents) including one death related to procedure.…”

Section: Discussionsupporting

confidence: 85%

“…One study reported their long term result of pulmonary stent experiencing 9.1% of complication rate (six out of 55 stents) including one death related to procedure. The complication rate has decreased with the refinement/development of equipments and skills 9)13)14)16)17)…”

Section: Discussionmentioning

confidence: 99%

“…That is not because of questions concerning its effectiveness and safety, but because of lack of interest among government and companies 10-12). Although few studies had demonstrated a high success rate after 20 years of experience, there has not been any multicenter-randomized controlled study 9)13)14). This study aimed at validating the effectiveness and investigating complications of pulmonary arterial stent implantation in a single institution during midterm follow up period 15)16)…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness and Safety of Percutaneous Transcatheter Implantation of Pulmonary Arterial Stent in Congenital Heart Disease

Kim

et al. 2012

Korean Circ J

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Background and ObjectivesPulmonary arterial stenosis is a relatively common complication after corrective operation of congenital heart disease. Unilateral stenosis of pulmonary arteries could result in decrease perfusion of affected lung, pulmonary regurgitation, or elevation of right ventricular pressure. Eventually there are increasing risks of right ventricular failure, arrhythmia, or sudden death. However we have limited data of pulmonary arterial stent in paediatric population as the treatment of branch pulmonary stenosis. This study aimed at validating the effectiveness and investigating complications of pulmonary arterial stent implantation in a single institution during mid-term follow up period.Subjects and MethodsA total of 42 patients (50 stents) were implanted for treating branch pulmonary arterial stenosis. We used cardiac catheterization for comparing diameter after stent implantation directly and lung perfusion scan indirectly. We also investigated any adverse effect relating the procedure.ResultsPercent stenosis of stenotic lesions were decreased from 54.1±10.7% to 22.8±12.5% (p<0.001) and degree of decrement in affected lung perfusion was declined from 22.7±8.0% to 10.3±9.0% (p<0.001) immediately and lasts during mid-term follow up period. Complication rate relating the procedure was 12% (6 out of 12) and there was no mortality case.ConclusionThis series showed immediate and short term effectiveness of pulmonary arterial stent in congenital heart defects. We concluded that percutaneous transcatheter implantation of pulmonary arterial stent was safe and effective during short and mid-term follow up period.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effectiveness and Safety of Percutaneous Transcatheter Implantation of Pulmonary Arterial Stent in Congenital Heart Disease

Kim

et al. 2012

Korean Circ J

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“…Numerous reports have shown that stent implantation is a safe and effective treatment that provides excellent immediate and long-term outcomes. 1 2 3) Stent implantation can dilate parts of a stenotic lesion and can also provide a support structure around it to prevent recoil. Nowadays, stent implantation is used widely and effectively in patients with CHD, especially in cases of recoiling with balloon angioplasty, even though it is still considered “off label” i.e., not approved by the U.S. Food and Drug Administration for conditions such as branch pulmonary artery stenosis (PAS), coarctation of the aorta (CoA), and venous system stenotic lesions.…”

Section: Introductionmentioning

confidence: 99%

The outcome of percutaneous stent implantation in congenital heart disease: experience of a single institute

et al. 2018

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PurposeThe efficacy of percutaneous stent implantation for congenital heart disease (CHD) in Korea, where stent availability is limited, has not been determined. This study evaluated the acute and midterm results of stent implantation in different CHD subgroups.MethodsStents were implanted in 75 patients with 81 lesions: (1) pulmonary artery stenosis (PAS) group, 56 lesions in 51 patients; (2) coarctation of the aorta (CoA) group, 5 lesions in 5 patients; (3) Fontan group, 13 lesions in 12 patients; (4) ductal stent group, 3 lesions in 3 patients; and (5) other CHD group, 4 lesions in 4 patients. Mean follow-up duration was 2.1 years (0.1–4 years). Medical records were reviewed retrospectively.ResultsThe minimum lumen diameter (MLD) in PAS and CoA increased from 5.0±1.9 mm and 8.4±1.6 mm to 10.1±3.6 mm and 12.3±2.5 mm, respectively (P<0.01). In the PAS group, pressure gradient decreased from 25.7±15.6 mmHg to 10.4±10.1 mmHg, and right ventricular to aortic pressure ratio from 0.56±0.21 to 0.46±0.19. In the CoA group, the pressure gradient decreased from 50±33 mmHg to 17±8 mmHg. In the ductal stent group, the MLD of the ductus increased from 2.3 mm to 4.3 mm and arterial oxygen saturation from 40%–70% to 90%. No deaths were associated with stent implantation. Stent migration occurred in 3 patients, but repositioning was successful in all. Stent redilation was performed successfully in 26 cases after 29±12 months.ConclusionPercutaneous stent implantation was safe and effective, with acceptable short and mid-term outcomes in Korean CHD patients.

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“…Nevertheless, we should try to use an open-cell stent such as the Mega LD or Maxi LD (EV3, Plymouth, MN, USA) in case of unavoidable jailing side branches. Regarding further stent dilation or additional stent implantation, several studies6-8) confirmed its safety and effectiveness, and Stapleton et al7) found that patients who had their initial stents placed before age 10 years had an increased risk of needing further interventions at subsequent catheterizations. Initial vessel diameter or percent change in vessel diameter post stent were not associated with increased risk for repeat interventions.…”

mentioning

confidence: 99%

Pulmonary Artery Stents-Still "Off Label"

Kim

2012

Korean Circ J

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Stenting in Congenital Heart Disease

Cited by 27 publications

References 20 publications

Effectiveness and Safety of Percutaneous Transcatheter Implantation of Pulmonary Arterial Stent in Congenital Heart Disease

Effectiveness and Safety of Percutaneous Transcatheter Implantation of Pulmonary Arterial Stent in Congenital Heart Disease

The outcome of percutaneous stent implantation in congenital heart disease: experience of a single institute

Pulmonary Artery Stents-Still "Off Label"

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