RT Journal Article
SR Electronic
T1 Stenting of the ductus arteriosus and banding of the pulmonary arteries: basis for various surgical strategies in newborns with multiple left heart obstructive lesions
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 645
OP 650
DO 10.1136/heart.89.6.645
VO 89
IS 6
A1 I Michel-Behnke
A1 H Akintuerk
A1 I Marquardt
A1 M Mueller
A1 J Thul
A1 J Bauer
A1 K J Hagel
A1 J Kreuder
A1 P Vogt
A1 D Schranz
YR 2003
UL http://heart.bmj.com/content/89/6/645.abstract
AB Objective: To present an institutional experience with stent placement in the arterial duct combined with bilateral banding of the pulmonary artery branches as a basis for various surgical strategies in newborns with hypoplastic left heart obstructive lesions.Design: Observational study.Setting: Paediatric heart centre in a university hospital.Patients: 20 newborns with various forms of left heart obstructive lesions and duct dependent systemic blood flow.Interventions: Patients underwent percutaneous ductal stenting and surgical bilateral pulmonary artery banding. Atrial septotomy by balloon dilatation was performed as required, in one premature baby by the transhepatic approach.Main outcome measures: Survival; numbers of and reasons for palliative and corrective cardiac surgery.Results: One patient died immediately after percutaneous ductal stenting. One patient died in connection with the surgical approach of bilateral pulmonary banding. Stent and ductal patency were achieved for up to 331 days. Two patients underwent heart transplantation and two patients died on the waiting list. Ten patients had a palliative one stage procedure with reconstruction of the aortic arch and bidirectional cavopulmonary connection at the age of 3.5–6 months. There was one death. One patient is still awaiting this approach. Two patients received biventricular repair. In one, biventricular repair will soon be provided.Conclusions: Stenting the arterial duct combined with bilateral pulmonary artery banding in newborns with hypoplastic left heart or multiple left heart obstructive lesions allows a broad variation of surgical strategies depending on morphological findings, postnatal clinical conditions, and potential ventricular growth.