title: Hybrid Pulmonary Artery Stenting at the Bidirectional Glenn or Fontan Operation in Patients With Single Ventricle Congenital Heart Disease.
abstract: Stenosis of the retroaortic pulmonary artery is common in patients with single ventricle heart disease. Intraoperative hybrid stenting at the bidirectional Glenn or Fontan operation can treat this lesion and avoid a complex surgical arterioplasty.
  
  
  
  Patients who underwent intraoperative stent implantation to the retroaortic pulmonary artery during the bidirectional Glenn or Fontan operation at our center between January 2005 and July 2014 were retrospectively identified.
  
  
  
  Thirteen patients were included with a median weight of 8 kg (5.6-14.4 kg) and age of 6 months (4 months-3.8 years). All had undergone Norwood operation, and eight (62%) had hypoplastic left heart syndrome. Eight (62%) underwent stent placement during bidirectional Glenn and five (38%) during Fontan operation. Ten patients had one stent placed, and three had two overlapping stents. The median diameter of the stenotic vessel was 3 mm (2.0-5.5 mm) and diameter of the balloon used for stent expansion was 7 mm (5-10 mm). Two complications occurred including pulmonary hemorrhage from presumed wire perforation and left main stem bronchus compression requiring stent removal. No patient required stent intervention in the postoperative period, and all were discharged from the hospital. At a median follow-up of 1.3 years (2 months-7.1 years), six patients underwent interval dilation to account for somatic growth.
  
  
  
  Hybrid stenting of the retroaortic pulmonary artery at the bidirectional Glenn or Fontan operation is an effective treatment of pulmonary artery stenosis and prevents the need for a complex surgical arterioplasty.
authors.affiliation: The Heart Center, Arnold Palmer Hospital for Children, College of Medicine, University of Central Florida, Orlando, FL, USA matthew.schwartz@orlandohealth.com.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Schwartz
authors.affiliation: The Heart Center, Arnold Palmer Hospital for Children, College of Medicine, University of Central Florida, Orlando, FL, USA.
authors.forename: William M
authors.initials: WM
authors.lastname: DeCampli
authors.affiliation: The Heart Center, Arnold Palmer Hospital for Children, College of Medicine, University of Central Florida, Orlando, FL, USA.
authors.forename: Kamal
authors.initials: K
authors.lastname: Pourmoghadam
authors.affiliation: The Heart Center, Arnold Palmer Hospital for Children, College of Medicine, University of Central Florida, Orlando, FL, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Iacono
authors.affiliation: The Heart Center, Arnold Palmer Hospital for Children, College of Medicine, University of Central Florida, Orlando, FL, USA.
authors.forename: David
authors.initials: D
authors.lastname: Nykanen
mesh_terms: D019917:Blood Vessel Prosthesis Implantation; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D018729:Fontan Procedure; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000601:surgery*; D007223:Infant; D008297:Male; D058327:Norwood Procedures; D011651:Pulmonary Artery / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: hybrid; pulmonary artery; stent; univentricular heart