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Comparison of self-expandable and balloon-expanding stents for hybrid ductal stenting in hypoplastic left heart complex

Published online by Cambridge University Press:  30 August 2016

Sebastian Goreczny ,
Shakeel A. Qureshi ,
Eric Rosenthal ,
Thomas Krasemann ,
Mohamed S. Nassar ,
David R. Anderson  and
Gareth J. Morgan
Sebastian Goreczny
Affiliation:
Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom Department of Cardiology, Polish Mother’s Memorial Hospital, Research Institute, Lodz, Poland
Shakeel A. Qureshi
Affiliation:
Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
Eric Rosenthal
Affiliation:
Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
Thomas Krasemann
Affiliation:
Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
Mohamed S. Nassar
Affiliation:
Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
David R. Anderson
Affiliation:
Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
Gareth J. Morgan*
Affiliation:
Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
*
Correspondence to: Dr G. J. Morgan, Department of Congenital Heart Disease, St Thomas’s Hospital, Westminster Bridge Rd, London SE1 7EH, United Kingdom. Tel: +44 20 7188 4547; Fax: +44 20 7188 4546; E-mail: gareth.morgan@gstt.nhs.uk
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Abstract

Objectives

We aimed to compare the procedural and mid-term performance of a specifically designed self-expanding stent with balloon-expandable stents in patients undergoing hybrid palliation for hypoplastic left heart syndrome and its variants.

Background

The lack of specifically designed stents has led to off-label use of coronary, biliary, or peripheral stents in the neonatal ductus arteriosus. Recently, a self-expanding stent, specifically designed for use in hypoplastic left heart syndrome, has become available.

Methods

We carried out a retrospective cohort comparison of 69 neonates who underwent hybrid ductal stenting with balloon-expandable and self-expanding stents from December, 2005 to July, 2014.

Results

In total, 43 balloon-expandable stents were implanted in 41 neonates and more recently 47 self-expanding stents in 28 neonates. In the balloon-expandable stents group, stent-related complications occurred in nine patients (22%), compared with one patient in the self-expanding stent group (4%). During follow-up, percutaneous re-intervention related to the ductal stent was performed in five patients (17%) in the balloon-expandable stent group and seven patients (28%) in self-expanding stents group.

Conclusions

Hybrid ductal stenting with self-expanding stents produced favourable results when compared with the results obtained with balloon-expandable stents. Immediate additional interventions and follow-up re-interventions were similar in both groups with complications more common in those with balloon-expandable stents.

Keywords

Hypoplastic left heart syndromehybrid procedureductal stenting
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 5 , July 2017 , pp. 837 - 845
Copyright
© Cambridge University Press 2016 

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