Stenting in paediatric and adult congenital heart diseases: A French multicentre study in the current era

Abstract

Background.-Many stents are used off-label during the management of congenital heartdiseases (CHD).Aims.-To describe indications for, results of, and adverse events associated with stenting inCHD in current practice.Methods.-Participation in this study was proposed to all catheterization laboratories thatspecialize in CHD in France (M3C network). All paediatric and adult CHD cases with stentimplantation in 2013 were included retrospectively.Results.-Overall, 207 stents were implanted in 151 patients across 11 centres. Median age was13.7 years (range, 5 days to 70.1 years). Main procedure indications were branch pulmonaryartery angioplasty (n = 46, 29.1%), aortic (re)coarctation stenting (n = 43, 27.2%), percutaneouspulmonary valve implantation (n = 32, 20.2%) and ductus arteriosus stenting (n = 14, 8.9%). Themain stents implanted were the CP StentTM(n = 61, 29.5%), the MaxTMLD stent (n = 43, 20.8%),the Valeo® stent (n = 28, 13.5%) and valved stents (n = 30, 14.5%). Procedures were consideredsuccessful in 96.8% of cases (95% confidence interval [CI] 92.8-99.0%). Adverse events wereobserved in 23 procedures (14.7%, 95% CI 9.5-21.0%). Ductus arteriosus stenting (odds ratio12.4, 95% CI 2.0-77.5; P < 0.01) and pulmonary revalvulation (odds ratio 5.9, 95% CI 1.1-32.3;P = 0.04) were risk markers for stent-related adverse events.Conclusions.-Stents are used in various CHD catheterization procedures, from infancy to adultage. The adverse events rate is significant and is related to the type of procedure.