Stenting of stenotic aortopulmonary collaterals in non-surgically treated adolescent or adult patients with pulmonary atresia, ventricular septal defect and multiple aortopulmonary collaterals

Abstract

OBJECTIVES: To present our experience with stent implantations in non-surgically treated patients with pulmonary atresia, ventricular septal defect and stenotic aortopulmonary collaterals. METHODS: Between April 2007 and June 2009, 6 stents in 4 patients were implanted into stenosed segments of MAPCAs. The median age and weight of patients at stent implantation were 24 years (range 13-34 years) and 58.5 kg (range 56-70 kg), respectively. RESULTS: All implantations were successfully performed; there were no procedure associated complications. The median diameter increase of stenosed MAPCAs was 107 %. The mean arterial blood saturation increased from mean 78 % to 84 %. An early increase in the median exercise duration measured by 6MWT was 36 %. Neointimal in-stent fi broproliferation in 4/6 stents and stent fracture in 1/6 patients occured in mid-term follow-up. CONCLUSION: Percutaneous catheterizational stent implantation into stenosed segments of MAPCAs is a palliative procedure, that might improve quality of life of non-surgically treated patients with PA, VSD, MAPCAs. Neointimal in-stent fi broproliferation and stent fracture can be expected as complications in mid-term follow-up. CT-angiography is recommended to confi rm these complications in progressive satO 2 decrease (Fig. 3, Ref. 12). Text in PDF www.elis.sk.

Basic Concepts and Insights into Aortopulmonary Collateral Arteries in Congenital Heart Diseases

“… 59 An alternate option is endovascular stent placement that has high initial success rates. 60 61 62 …”