ORIGINAL ARTICLE |
|
Year : 2021 | Volume
: 34
| Issue : 3 | Page : 1179-1183 |
|
Duct-dependent cyanotic neonates with patent ductus arteriosus stenting pose a unique challenge for the next stage of surgical intervention
Ayman R Abdelrehim1, Syed Aitizaz2, Saad Q Khoshhal3, Mansour B Almutairi2, Mustafa A Al-Muhaya2
1 Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt; Pediatric Cardiac Surgery Department, Madina Cardiac Center (MCC), Madina, Saudi Arabia 2 Pediatric Cardiac Surgery Department, Madina Cardiac Center (MCC), Madina, Saudi Arabia 3 Pediatric Cardiac Surgery Department, Madina Cardiac Center (MCC); Faculty of Medicine, Taebah University, Madina, Saudi Arabia
Correspondence Address:
Ayman R Abdelrehim Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Menoufia
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/mmj.mmj_12_21
|
|
Objective
To study the role of patent ductus arteriosus (PDA) stenting in the management of single-ventricle patients and the surgical difficulties facing the surgeons in the next stages of surgical procedures.
Background
Thirty consecutive neonates with cyanotic duct-dependent lesions were initially palliated with (PDA) stenting in our center. Eighteen of them had undergone one or more surgical procedures. We retrospectively assessed the indexed growth of pulmonary arteries (PA) over a period of time and the requirement of further rehabilitation of PAs in these patients.
Patients and methods
From January 2014 to December 2018, 30 neonates with cyanotic congenital heart diseases underwent PDA stenting as initial palliation; 60% were ventilated before the procedure, which resulted in 100% success. All patients were followed up regularly by monitoring of PA size imaging. Eighteen patients of this group underwent further surgical procedures.
Results
Ninety percent of the neonates had stenosis of the PA branches before PDA stenting. The indexed PA branch size was significantly smaller, which increased after stenting of PDA. At the time of the next surgical procedures (Glenn, etc.), stent division/ligation was required in addition to PA plasty in 90% of patients.
Conclusions
PDA stenting provides efficient palliation in cyanotic neonates. Despite the origin of stenosis, the stent allowed growth in the size of both PAs. However, the majority required surgical augmentation and further stenting of PAs in the mid-term follow-up.
|
|
|
|
[FULL TEXT] [PDF]* |
|
|
|