title: Fate of Hypoplastic Pulmonary Arteries After Arterial Duct Stenting in Congenital Heart Disease With Duct-Dependent Pulmonary Circulation.
abstract: OBJECTIVE
  This study sought to evaluate the impact of arterial duct (AD) stenting in promoting catch-up growth of hypoplastic pulmonary artery (PA) tree in congenital heart disease with duct-dependent pulmonary circulation (CHD-DPC).
  
  
  BACKGROUND
  Significant and balanced PA growth following AD stenting has already been consistently reported in the literature. However, no data are so far available about the role of this approach in severe PA hypoplasia, which significantly impacts the risk of surgical repair.
  
  
  METHODS
  Pre-surgical angiographic PA evaluation was performed in 45 patients with confluent PAs submitted to neonatal AD stenting as palliation of CHD-DPC. PA growth was evaluated as Nakata Index and McGoon ratio as well as individual PA z-score changes, both in the whole population and according to the original vessel size (Nakata Index <100 mm(2)/m(2), Group I [n = 15] vs. Nakata Index >100 mm(2)/m(2), Group II [n = 30]).
  
  
  RESULTS
  Control angiography was performed 7.5 ± 6.5 months (median 6 months) after duct stenting, showing significant and balanced PA growth. The Nakata Index increased from 143 ± 73 mm(2)/m(2) to 270 ± 88 mm(2)/m(2) (124 ± 118%, p < 0.0001); left PA z-score from -0.7 ± 1.7 to 1.0 ± 1.4; right PA z-score from -0.6 ± 1.3 to 1.2 ± 1.3 (p < 0.0001 for both comparisons). Group I showed a greater increase of global PA growth (Nakata Index increase 227 ± 141% vs. 72 ± 57%, p < 0.001) as compared with Group II. Final PA size did not significantly differ between the groups (246 ± 105 mm(2)/m(2) vs. 282 ± 78 mm(2)/m(2), p = NS).
  
  
  CONCLUSIONS
  Percutaneous AD stenting is highly effective in promoting a significant and balanced catch-up growth of diminutive PAs, being therefore advisable in this subset of patients as a reliable alternative to surgical palliation.
authors.affiliation: Paediatric Cardiology and Paediatric Cardiac Surgery, A.O.R.N. "Ospedali dei Colli," 2nd University of Naples, Naples, Italy. Electronic address: santoropino@tin.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Santoro
authors.affiliation: Paediatric Cardiology and Paediatric Cardiac Surgery, A.O.R.N. "Ospedali dei Colli," 2nd University of Naples, Naples, Italy.
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Gaio
authors.affiliation: Paediatric Cardiology and Paediatric Cardiac Surgery, A.O.R.N. "Ospedali dei Colli," 2nd University of Naples, Naples, Italy.
authors.forename: Giovanbattista
authors.initials: G
authors.lastname: Capozzi
authors.affiliation: Paediatric Cardiology and Paediatric Cardiac Surgery, A.O.R.N. "Ospedali dei Colli," 2nd University of Naples, Naples, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Giugno
authors.affiliation: Paediatric Cardiology and Paediatric Cardiac Surgery, A.O.R.N. "Ospedali dei Colli," 2nd University of Naples, Naples, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Palladino
authors.affiliation: Paediatric Cardiology and Paediatric Cardiac Surgery, A.O.R.N. "Ospedali dei Colli," 2nd University of Naples, Naples, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Capogrosso
authors.affiliation: Paediatric Cardiology and Paediatric Cardiac Surgery, A.O.R.N. "Ospedali dei Colli," 2nd University of Naples, Naples, Italy.
authors.forename: Angelo Fabio
authors.initials: AF
authors.lastname: D'Aiello
authors.affiliation: Paediatric Cardiology and Paediatric Cardiac Surgery, A.O.R.N. "Ospedali dei Colli," 2nd University of Naples, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Caianiello
authors.affiliation: Paediatric Cardiology and Paediatric Cardiac Surgery, A.O.R.N. "Ospedali dei Colli," 2nd University of Naples, Naples, Italy.
authors.forename: Maria Giovanna
authors.initials: MG
authors.lastname: Russo
mesh_terms: D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008670:Metals; D010166:Palliative Care; D011474:Prosthesis Design; D011651:Pulmonary Artery / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000254:growth & development*; D011652:Pulmonary Circulation; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals
keywords: arterial duct; congenital heart disease; cyanosis; pulmonary artery growth; stent