title: Ductus arteriosus stenting: A promising percutaneous palliation in patients with duct-dependent pulmonary circulation.
abstract: OBJECTIVE
  We aimed to study the feasibility and outcomes of ductal stenting in patients with duct-dependent pulmonary blood flow (PBF).
  
  
  METHODS
  Duct-dependent hypoxic patients with confluent pulmonary artery (PA) branches were enrolled for ductal stenting and followed regularly.
  
  
  RESULTS
  Sixty patients, with a median age of 12 (1-1095) days and weight of 2.8 (2.2-8.9) kg, were enrolled. Median right PA (RPA) and left PA (LPA) Z-scores were -1.23 (-10.54 to 2.81) and -0.96 (-8.03 to 3.0), respectively. Mean narrowest ductal diameter was 1.73±0.57 mm and length was 12.78±3.32 mm. Sixty-four stents with mean diameter of 4.21±0.32 mm and length of 14.34±3.44 mm were deployed in 59 patients. The procedure was unsuccessful in one. Post-stenting mean oxygen saturation (SO2) increased significantly from baseline of 68.88±7.47% to 90.43±6.04% (p<0001). Complications included pulmonary edema in one patient and acute stent occlusion in another. At a median follow-up of eight (2-14) months, mean SO2(80.04±7.54%) was significantly higher than baseline (p<0.0001). Median RPA and LPA Z-scores, 0.56 (-2.89 to 3.29) and -0.02 (-2.81 to 3.86), respectively, were significantly higher than baseline. Six patients required re-interventions (shunt in three and angioplasty in three). Six patients died, three due to sepsis and another three with worsened cyanosis due to impaired PBF, probably due to ductal occlusion.
  
  
  CONCLUSIONS
  Ductal stenting is an effective palliation in patients with duct-dependent PBF. It maintains adequate SO2and promotes balanced PA growth at mid-term follow-up.
authors.affiliation: UN Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, India. Electronic address: docabs4u@gmail.com.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Raval
authors.affiliation: UN Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, India.
authors.forename: Bhavesh
authors.initials: B
authors.lastname: Thakkar
authors.affiliation: UN Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Madan
authors.affiliation: Paediatric Cardiology and Cardiothoracic Department, Royal Brompton and Harefield Hospital Foundation NHS Trust, London, United Kingdom.
authors.forename: Nilesh
authors.initials: N
authors.lastname: Oswal
authors.affiliation: Delhi Heart Institute and Multispeciality Hospital, Bathinda, India.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Garg
authors.affiliation: UN Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, India.
authors.forename: Rhshikesh
authors.initials: R
authors.lastname: Umalkar
authors.affiliation: UN Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, India.
authors.forename: Komal
authors.initials: K
authors.lastname: Shah
authors.affiliation: UN Mehta Institute of Cardiology and Research Centre (UNMICRC), Ahmedabad, India.
authors.forename: Bhumika
authors.initials: B
authors.lastname: Maheriya
mesh_terms: D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D011652:Pulmonary Circulation; D015607:Stents; D016896:Treatment Outcome
keywords: Arterial oxygen saturation; Circulação pulmonar dependente de canal; Duct-dependent pulmonary circulation; Ductus arteriosus stenting; Implantação de stent em canal arterial; Saturação de oxigénio nas artérias; Stent