RT Journal Article
SR Electronic
T1 Right ventricular outflow tract stent versus BT shunt palliation in Tetralogy of Fallot
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1985
OP 1991
DO 10.1136/heartjnl-2016-310620
VO 103
IS 24
A1 Daniel Quandt
A1 Bharat Ramchandani
A1 Gemma Penford
A1 John Stickley
A1 Vinay Bhole
A1 Chetan Mehta
A1 Timothy Jones
A1 David James Barron
A1 Oliver Stumper
YR 2017
UL http://heart.bmj.com/content/103/24/1985.abstract
AB Objective This study sets out to compare morbidity, mortality and reintervention rates after stenting of the right ventricular outflow tract (RVOT) versus modified Blalock-Taussig shunt (mBTS) for palliation in patients with tetralogy of Fallot (ToF)-type lesions.Methods Retrospective case review study evaluating 101 patients (64 males) with ToF lesions who underwent palliation with either mBTS (n=41) or RVOT stent (n=60) to augment pulmonary blood flow over a 10-year period. Procedure-related morbidity, mortality and reintervention rates were assessed and compared.Results Admission rate to paediatric intensive care unit (PICU) was lower in the RVOT stent group (22% vs 100%; p<0.001). Thirty-day mortality in the RVOT stent group was (1/60 (1.7%)) compared with (2/41 (4.9%)) in the mBTS group (p=0.565). Mortality until surgical repair was comparable in both groups (5/60, 8.4%, including three non-cardiac death in the RVOT stent group vs 2/41, 4.9% (p=0.698)). Total hospital length of stay was shorter for the RVOT stent group (median 7 days vs 14 days; p<0.003). Time to surgical repair was shorter in the RVOT stent group (median 232 days, IQR 113–360) compared with the mBTS group (median 428 days, IQR 370–529; p<0.001) due to improved pulmonary arterial growth.Conclusion RVOT stenting in Fallot-type lesions can be accomplished safely, with lower PICU admission rate, a shorter hospital length of stay and shorter duration of palliation until complete repair compared with mBTS palliation.