Stenting of Native Right Ventricular Outflow Tract Obstructions in Symptomatic Infants

J Interv Cardiol. 2015 Jun;28(3):279-87. doi: 10.1111/joic.12198. Epub 2015 May 20.

Abstract

Objective: To assess feasibility, safety and effectiveness of right ventricular outflow tract (RVOT) stenting in symptomatic young infants.

Methods: Multicentre evaluation of 35 patients intended to undergo RVOT stenting in 11 pediatric cardiac centres from 2009 to August 2011.

Results: Median age and weight at the time of first stent implantation were 8 weeks and 3.3 kg, with 40% of patients <3 kg. A total of 19 patients had suffered from hypoxemic spells, 8 patients were ventilated, 6 on inotropic support and 5 on prostaglandin infusion. Severe concomitant malformations were present in 11 patients, and acute infections in 2. Stenting of the RVOT was successfully performed in 33 patients, improving oxygen saturation from a median of 77 to 90% 2 days after intervention. Besides the 2 patients in whom RVOT stenting was not successful for technical reasons, there were no procedural complications. In 17 of 33 patients, 1-3 reinterventions were performed during follow-up, less than half of those were reinterventions in the RVOT. A total of 27 patients have undergone successful surgical repair 4-162 (median 19.5) weeks after initial RVOT stent implantation, 2 patients are still waiting. There were no perioperative deaths.

Conclusions: Stenting of the RVOT provides a safe and effective management strategy for initial palliation in symptomatic young infants, including those patients not suitable or at higher risk for surgical therapy.

Publication types

  • Multicenter Study

MeSH terms

  • Cardiac Catheterization*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Hypoxia / etiology
  • Infant
  • Male
  • Oxygen / blood
  • Retreatment
  • Stents*
  • Ventricular Outflow Obstruction / congenital
  • Ventricular Outflow Obstruction / therapy*

Substances

  • Oxygen