Progress in
Pediatric Cardiology 50 (2018) 17–22
DOI 10.1016/j.ppedcard.2018.06.002
Received 14 March
2018; Received in revised form 12 June 2018; Accepted 13 June 2018
Available online
19 June 2018
© 2018
Elsevier B.V.
Abraham Rothman, MD, Kaushal Dosani,
MD, William N Evans, MD, Alvaro Galindo, MD
Source
Children’s Heart
Center Nevada, 3006 S Maryland Pkwy, Ste 690, Las Vegas, Nevada 89109, USA.
University of
Nevada Las Vegas, School of Medicine, Department of Pediatrics, 4505 S.
Maryland Pkwy, Las Vegas, NV 89154
Email: arothman@childrensheartcenter.com
Abstract
We describe our experience with stenting the
patent ductus arteriosus originating from the left subclavian artery or
innominate artery in patients with a right aortic arch. Patent ductus
arteriosus stenting is an alternative to surgical shunt placement in patients
with congenital cardiac malformations. Four patients with an elongated patent
ductus arteriosus arising from either the left subclavian artery of the
innominate artery underwent implantation of multiple stents. The diameter of
the stents ranged from 3.5 to 4.5mm and the length from 8 to 15 mm. Three
neonates had tetralogy of Fallot and a right aortic arch, and one 14 month-old patient had discontinuous pulmonary arteries, a
right aortic arch, and a ventricular septal defect. In the three neonates with tetralogy
of Fallot, we employed an antegrade venous approach. Stent implantation was
successful acutely and without complications in all four patients. One patient
developed stent restenosis and underwent two additional stent re-dilations 2
months and 5 months after the initial procedure, respectively. The 14 month-old patient underwent planned re-dilation of the
stents one month later. All the patients underwent successful complete repair
ranging from 149 to 338 days after stent placement. Patent ductus arteriosus
stenting in patients with a right aortic arch and a ductus arising from the
left subclavian or innominate artery can be performed successfully
using multiple stents, particularly in
newborns and from a femoral venous approach. Complete repair can be postponed
for several months.
https://doi.org/10.1016/j.ppedcard.2018.06.002