title: Palliative stenting of patent ductus arteriosus in older children and young adults with congenital cyanotic heart disease.
abstract: OBJECTIVE
  To describe the indications, technique and results (early and short-term follow-up) of palliative patent ductus arteriosus (PDA) stenting in selected patients (2 years and older) with congenital cyanotic heart disease with reduced pulmonary blood flow who were not candidates for definitive surgery in the immediate future.
  
  
  BACKGROUND
  Stenting of PDA as a palliation has been advocated as safe and effective procedure in neonates, but this modality is underutilized for children and adults.
  
  
  METHODS
  Hospital records of patients (≥2 years) undergoing PDA stenting between January 2007 and September 2009 were reviewed. The access and approach was dictated by the anatomy of the PDA. A coronary guiding catheter or a long sheath was used to access the PDA. Coronary or peripheral stents were used for stenting.
  
  
  RESULTS
  Fifteen patients with median age 14 years (range: 2-18 years); median weight 17.5 kg (range: 7-57 Kg) were included. Indication for intervention was hypoxia (mean saturation 69% ± 8.9%, hemoglobin 19.8 ± 2.69 g/dl), unsuitable anatomy or economic considerations. Successful stenting was accomplished in all (mean fluoroscopy time of 24.6 ± 16.7 min) with no complications and the saturations improved to mean of 88% ± 2.3 %. The most recent oxygen saturations on follow-up (median: 13 months; range: 1-21 months) were 82% ± 2.8%. One patient underwent corrective repair.
  
  
  CONCLUSIONS
  PDA stenting can provide effective palliation in selected older patients with cyanotic congenital heart disease.
authors.affiliation: Department of Pediatric Cardiology, Amrita Institute of Medical Sciences and Research Center, Cochin, Kerala, India.
authors.forename: Edwin
authors.initials: E
authors.lastname: Francis
authors.forename: Shine
authors.initials: S
authors.lastname: Kumar
authors.forename: Raman Krishna
authors.initials: RK
authors.lastname: Kumar
mesh_terms: D000015:Abnormalities, Multiple; D000293:Adolescent; D006328:Cardiac Catheterization / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome