title: Pulmonary artery growth after arterial duct stenting in completely duct-dependent pulmonary circulation.
abstract: OBJECTIVE
  Significant and balanced pulmonary artery (PA) growth following arterial duct (AD) stenting has already been reported in literature. However, no data are so far available about the role of this percutaneous approach in promoting PA growth in the case of congenital heart disease (CHD) with completely duct-dependent pulmonary blood flow (CDD-PBF). Aim of this study was to evaluate the effect of AD stenting in this pathophysiological setting.
  
  
  METHODS
  PA growth was evaluated as Nakata index and McGoon ratio as well as individual PA z-score changes in 49 patients submitted to neonatal AD stenting according to their pathophysiology (CDD-PBF (n=15) versus multiple PBF sources (n=34)).
  
  
  RESULTS
  Control angiography was performed 7.2±6.4 months (range 1-8, median 6) after AD stenting. In the whole population, significant and balanced PA growth was recorded (Nakata index+122±117%; left pulmonary artery (LPA) z-score +84±52%; right pulmonary artery (RPA) z-score +92±53% versus preprocedure, p<0.0001 for all comparisons). Percentage increase of global and branch vessel size was not significantly different in patients with CDD-PBF compared with those with multiple PBF sources (Nakata index 89±90% vs 144±124%; LPA z-score 63±40% vs 89±58%; RPA z-score 74±35% vs 100±57%, p=NS for all comparisons) as was final absolute PA size (Nakata index 237±90 vs 289±80 mm(2)/m(2), p=NS).
  
  
  CONCLUSIONS
  Percutaneous AD stenting was associated with significant and balanced PA growth in CHD with completely duct-dependent pulmonary circulation over a short-term follow-up. Thus, it may be considered as an alternative to surgical palliation in this subset of patients.
authors.affiliation: Department of Paediatric Cardiology, A.O.R.N. 'Ospedali dei Colli', 2nd University of Naples, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Santoro
authors.affiliation: Department of Paediatric Cardiology, A.O.R.N. 'Ospedali dei Colli', 2nd University of Naples, Naples, Italy.
authors.forename: Giovanbattista
authors.initials: G
authors.lastname: Capozzi
authors.affiliation: Department of Paediatric Cardiology, A.O.R.N. 'Ospedali dei Colli', 2nd University of Naples, Naples, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Capogrosso
authors.affiliation: Department of Paediatric Cardiology, A.O.R.N. 'Ospedali dei Colli', 2nd University of Naples, Naples, Italy.
authors.forename: Heba Talat
authors.initials: HT
authors.lastname: Mahmoud
authors.affiliation: Department of Paediatric Cardiology, A.O.R.N. 'Ospedali dei Colli', 2nd University of Naples, Naples, Italy.
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Gaio
authors.affiliation: Department of Paediatric Cardiology, 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: Department of Paediatric Cardiology, 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: D000792:Angiography; D006328:Cardiac Catheterization / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010166:Palliative Care; D011379:Prognosis; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000254:growth & development* / Q000601:surgery; D011652:Pulmonary Circulation / Q000502:physiology*; D020127:Recovery of Function; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors