Hostname: page-component-77c89778f8-gvh9x Total loading time: 0 Render date: 2024-07-22T18:59:09.430Z Has data issue: false hasContentIssue false
  • English
  • Français

Balloon angioplasty of bidirectional Glenn anastomosis

Published online by Cambridge University Press:  11 August 2020

Amr Matoq Open the ORCID record for Amr Matoq [Opens in a new window]  and
Wolfgang Radtke
Amr Matoq
Affiliation:
Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, DE19803, USA
Wolfgang Radtke*
Affiliation:
Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, DE19803, USA
*
Author for correspondence: Wolfgang Radtke MD, Nemours Cardiac Center, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Rd, Wilmington, DE19803, USA. Tel: +1 302 651 6600; Fax: +1 302 651 6600. E-mail: Wolfgang.Radtke@nemours.org
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

We aim to assess the safety and efficacy of the transcatheter balloon dilation of superior cavopulmonary anastomosis (SCPA).

Background:

SCPA stenosis can lead to impaired pulmonary blood flow, hypoxemia and development of veno-venous collaterals with right-to-left shunt. Balloon dilation of SCPA has been rarely reported and follow-up information is lacking.

Methods:

We performed a retrospective review of patients who underwent cardiac catheterisation and angioplasty of SCPA and reviewed patient’s demographics, diagnosis, SCPA surgery and post-operative course, catheterisation haemodynamics, procedural technique, angiography, and the findings of follow-up catheterisation.

Results:

Between 2008 and 2017, seven patients showed significant narrowing of SCPA and underwent balloon angioplasty, all of whom had undergone bidirectional Glenn (BDG). Indications for cardiac catheterisation included persistent pleural effusion, hypoxemia, and echocardiographic evidence of BDG stenosis or routine pre-Fontan assessment. Five patients had bilateral SCPA. The procedure was successful in all cases with increase in the stenosis diameter from a median of 3.3 mm (range 1.2–4.7 mm) to a median of 4.7 mm (range 2.6–7.8 mm). All patients had at least one follow-up cardiac catheterisation. Only one patient required repeat angioplasty at the 2.3-month follow-up with no further recurrence. Sustained results and interval growth were noted in all other cases during up to 29 months of follow-up. No adverse events were encountered.

Conclusion:

Based on our small series, balloon angioplasty of BDG stenosis is feasible and safe and appears to provide sustained improvement with interval growth and only the rare recurrence of stenosis.

Keywords

Single ventricleveno-venous collateralsstenosis
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 10 , October 2020 , pp. 1452 - 1457
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Lee, TM, Aiyagari, R, Hirsch, JC, Ohye, RG, Bove, EL, Devaney, EJ. Risk factor analysis for second-stage palliation of single ventricle anatomy. Ann Thorac Surg 2012; 93: 614–618; discussion 619.Google ScholarPubMed
Zampi, JD, Hirsch-Romano, JC, Armstrong, AK. Early cyanosis after stage II palliation for single ventricle physiology: etiologies and outcomes. World J Pediatr Congenit Heart Surg 2013; 4: 367–372.CrossRefGoogle ScholarPubMed
Hansen, JH, Runge, U, Uebing, A, Scheewe, J, Kramer, HH, Fischer, G. Cardiac catheterization and interventional procedures as part of staged surgical palliation for hypoplastic left heart syndrome. Congenit Heart Dis 2012; 7: 565–574.CrossRefGoogle ScholarPubMed
Reinhardt, Z, De Giovanni, J, Stickley, J, et al. Catheter interventions in the staged management of hypoplastic left heart syndrome. Cardiol Young 2014; 24: 212–219.CrossRefGoogle ScholarPubMed
Douglas, WI, Goldberg, CS, Mosca, RS, Law, IH, Bove, EL. Hemi-Fontan procedure for hypoplastic left heart syndrome: outcome and suitability for Fontan. Ann Thorac Surg 1999; 68: 1361–1367; discussion 1368.CrossRefGoogle ScholarPubMed
Cnota, JF, Allen, KR, Colan, S, et al. Superior cavopulmonary anastomosis timing and outcomes in infants with single ventricle. J Thorac Cardiovasc Surg 2013; 145: 1288–1296.CrossRefGoogle ScholarPubMed
Hansen, JH, Uebing, A, Furck, AK et al. Risk factors for adverse outcome after superior cavopulmonary anastomosis for hypoplastic left heart syndrome. Eur J Cardiothorac Surg 2011; 40: e43–e49.CrossRefGoogle ScholarPubMed
Iyer, GK, Van Arsdell, GS, Dicke, FP, McCrindle, BW, Coles, JG, Williams, WG. Are bilateral superior vena cavae a risk factor for single ventricle palliation? Ann Thorac Surg 2000; 70: 711–716.CrossRefGoogle ScholarPubMed
Ando, Y, Fukae, K, Hirayama, K, Oe, M, Iwai, T. Impact of bilateral superior venae cavae on outcome of staged Fontan procedure. Ann Thorac Surg 2014; 98: 2187–2193.CrossRefGoogle ScholarPubMed
Mendelsohn, AM, Dorostkar, PC, Moorehead, CP, et al. Stent redilation in canine models of congenital heart disease: pulmonary artery stenosis and coarctation of the aorta. Catheter Cardiovasc Diagn 1996; 38: 430–440.Google ScholarPubMed
Magee, AG, McCrindle, BW, Mawson, J, Benson, LN, Williams, WG, Freedom, RM. Systemic venous collateral development after the bidirectional cavopulmonary anastomosis: prevalence and predictors. J Am Coll Cardiol 1998; 32: 502.CrossRefGoogle ScholarPubMed
McElhinney, DB, Reddy, VM, Hanley, FL, Moore, P. Systemic venous collateral channels causing desaturation after bidirectional cavopulmonary anastomosis: evaluation and management. J Am Coll Cardiol 1997; 30: 817–824.CrossRefGoogle ScholarPubMed