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Catheter Cardiovasc Interv. 2011 Feb 15;77(3):395-9. doi: 10.1002/ccd.22797. Epub 2010 Nov 3.

Long-term outcomes of intraoperative pulmonary artery stent placement for congenital heart disease.

Author information

1
Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Pediatric Cardiology, Little Rock, Arkansas 72202, USA. mjangtuaco@uams.edu

Abstract

OBJECTIVE:

Our objective was to examine long-term outcomes of intraoperative pulmonary artery stents and determine risk factors for reintervention

BACKGROUND:

Short-term outcomes of intraoperative pulmonary artery stents have been reported previously. However, long-term results are unknown.

METHODS:

We conducted a retrospective review of patients who underwent intraoperative pulmonary artery stent placement for branch pulmonary artery stenosis.

RESULTS:

Ninety-six stents were implanted intraoperatively in 67 patients. Twenty-seven patients received two or more stents at initial intervention. Median patient age at initial stent placement was 1.8 years. Median post-inflation diameter was 8 mm. At a mean follow-up of 7.6±4.5 years, 49% of stents required reintervention (balloon angioplasty at catheterization in 28 patients and surgical revision in 19 patients). Actuarial freedom from reintervention at 2, 5, and 10 years was 68%, 49%, and 40%, respectively. In univariate analysis of time to first reintervention, age at implantation<2 yrs (P<0.0009) and initial post-inflation stent diameter<10 mm (P<0.0002) were associated with risk for reintervention. Multivariable Cox regression analysis showed age<2 years (P<0.005) and diagnosis of tetralogy of Fallot (p<0.002) or truncus arteriosus (P<0.007) to be significant risk factors for reintervention.

CONCLUSION:

Intraoperative placement of stents in the pulmonary arteries is an alternative to surgical angioplasty, but is associated with a high incidence of reintervention. Age<2 years and the diagnosis of tetralogy of Fallot or truncus arteriosus are risk factors for reintervention.

PMID:
20853358
DOI:
10.1002/ccd.22797
[Indexed for MEDLINE]

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