Stenting of stenotic aortopulmonary collaterals in non-surgically treated adolescent or adult patients with pulmonary atresia, ventricular septal defect and multiple aortopulmonary collaterals

Abstract

OBJECTIVES: To present our experience with stent implantations in non-surgically treated patients with pulmonary atresia, ventricular septal defect and stenotic aortopulmonary collaterals. METHODS: Between April 2007 and June 2009, 6 stents in 4 patients were implanted into stenosed segments of MAPCAs. The median age and weight of patients at stent implantation were 24 years (range 13-34 years) and 58.5 kg (range 56-70 kg), respectively. RESULTS: All implantations were successfully performed; there were no procedure associated complications. The median diameter increase of stenosed MAPCAs was 107 %. The mean arterial blood saturation increased from mean 78 % to 84 %. An early increase in the median exercise duration measured by 6MWT was 36 %. Neointimal in-stentfibroproliferation in 4/6 stents and stent fracture in 1/6 patients occured in mid-term follow-up. CONCLUSION: Percutaneous catheterizational stent implantation into stenosed segments of MAPCAs is a palliative procedure, that might improve quality of life of non-surgically treated patients with PA, VSD, MAPCAs. Neointimal in-stentfibroproliferation and stent fracture can be expected as complications in mid-term follow-up. CT-angiography is recommended to confirm these complications in progressive satO2 decrease.