[Early complications of stenting in children and young adults with congenital heart disease].
We report the early complications of stent implantation. Since 1/1/97 to 1/12/02, we implanted 91 stents in 76 patients. Median age and weight were 15 years (range 0.3-43) and 49 kg (range 3-96). Primary diagnosis were: pulmonary atresia with ventricular septal defect (n = 17), tetralogy of Fallot (n = 13), aortic coarctation (n = 15), transposition of the great arteries (n = 3), truncus arteriosus (n = 6), univentricular heart (n = 7), other anomalies (n = 28). Indications to stent implantation were: stenosis of the pulmonary outflow and/or pulmonary branches (n = 44), aortic recoarctation (n = 14), native aortic coarctation (n = 1), systemic venous channels obstruction (n = 14), other (n = 3). The stents were: Palmaz (n = 57), non premounted CP (n = 8), premounted CP (n = 3), Palmaz Corinthian (n = 19), self-expanding (n = 4). Procedural complications occurred in 24 patients (31%) and included: 11 balloon bursting, 8 stent slipping, 1 stent migration, 4 wall dissections. Five patients (21%) needed urgent surgery. Sixty three percent of complications occurred during pulmonary outflow or pulmonary branches stenting, 25% during stenting of the aortic arch, 12% during other procedures. All but 2 complications were observed with non premounted stents. In conclusion, the use of not premounted stents, although widely diffuse, has a not negligible incidence of complications, leading to longer procedures, to the use of a large variety of materials and needing more than occasionally a surgical solution. A larger use of premounted stents, when possible, is recommended.
Agnoletti
G
G
Service de cardiologie pédiatrique, groupe hospitalier Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris. gabriella.agnoletti@nck.ap-hop-paris.fr
Boudjemline
Y
Y
Aggoun
Y
Y
Abdel-Massih
T
T
Bonnet
C
C
Bonnet
D
D
Sidi
D
D
D000293:Adolescent; D000328:Adult; D000784:Aortic Dissection / Q000209:etiology; D002404:Catheterization / Q000009:adverse effects* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology; D006330:Heart Defects, Congenital / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D011666:Pulmonary Valve Stenosis / Q000628:therapy*; D011668:Pulmonary Veno-Occlusive Disease / Q000628:therapy*; D015607:Stents