title: Short-term result of ductus arteriosus stent implantation compared with surgically created shunts.
abstract: This report aims to compare the researchers' early experience with the safety, efficacy, short-term outcomes, and complications of patent ductus arteriosus (PDA) stents in neonates having duct-dependent pulmonary circulation with those of surgically created shunts. Between April 2009 and April 2011, 18 infants with duct-dependent pulmonary circulation underwent cardiac catheterization for PDA stenting as the first palliative procedure in a referral center. For comparison, 20 infants who underwent surgical aortopulmonary shunt placement in another center were used. Follow-up assessment included clinical examination, echocardiography, oxygen saturation, and cardiac catheterization studies. Access and stenting for the PDA were successful in 15 patients (83.3 %). The mean procedure time was 58.43 ± 41.25 min, and the mean fluoroscopy time was 18.81 ± 5.64 min. Three patients (20 %) in the stented group and 6 patients (30 %) in the surgical group died (P = 0.09). After a 6-month follow-up period, none of the patients had significant stent stenosis requiring reintervention. The oxygen saturation increase did not differ significantly between the two groups either immediately after the procedure or 6 months later (P > 0.5). The left pulmonary artery diameter, McGoon ratio, and Nakata index did not differ significantly between the two groups (P > 0.05), but the right pulmonary diameter was larger in the stented group (5.01 ± 0.45 vs 4.1 ± 0.49 mm; P = 0.0001). Stenting for the PDA is an appropriate alternative to surgical shunt creation in many patients with duct-dependent circulation. In our sample, the two groups did not differ significantly in terms of outcome or mortality.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Shiraz University of Medical Sciences, Namazi AV, Shiraz, Iran. amozgah@sums.ac.ir
authors.forename: Hamid
authors.initials: H
authors.lastname: Amoozgar
authors.forename: Sirous
authors.initials: S
authors.lastname: Cheriki
authors.forename: Mohammad
authors.initials: M
authors.lastname: Borzoee
authors.forename: Gholamhossein
authors.initials: G
authors.lastname: Ajami
authors.forename: Manouchehr
authors.initials: M
authors.lastname: Soltani
authors.forename: Maryam
authors.initials: M
authors.lastname: Ahmadipour
authors.forename: Farah
authors.initials: F
authors.lastname: Peiravian
authors.forename: Amirali
authors.initials: A
authors.lastname: Amirghofran
mesh_terms: D006348:Cardiac Surgical Procedures / Q000401:mortality; D004374:Ductus Arteriosus, Patent / Q000401:mortality / Q000601:surgery*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D061646:Operative Time; D018709:Statistics, Nonparametric; D015607:Stents; D016896:Treatment Outcome