Initial results and medium-term follow-up of stent implantation of patent ductus arteriosus in duct-dependent pulmonary circulation
Mazeni Alwi, MRCP*,*,
K. K. Choo, MRCP*,
Haifa Abdul Latiff, MD*,
Geetha Kandavello, MRCP*,
Hasri Samion, MD* and
M. D. Mulyadi, MD*
* National Heart Institute, Kuala Lumpur, Malaysia
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Figure 1 Pulmonary coarctation. (a) Left pulmonary artery stenosis; (b) bilateral branch pulmonary artery stenosis.
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Figure 2 Diagnoses of patients who underwent successful stent implantation. ccTGA = congenital corrected transposition of great arteries; DILV = double-inlet left ventricle; PA = pulmonary atresia; PAIVS = pulmonary atresia with intact ventricular septum; PS = pulmonary stenosis; TA = tricuspid atresia; TS = tricuspid stenosis; TGA = transposition of great arteries; TOF = tetralogy of Fallot; VSD = ventricular septal defect.
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Figure 3 Morphology of arterial duct. (a) Ductus arising normally from descending aorta and has a straight tubular course; (b) "vertical duct" arising from beneath the aortic arch; (c) ductus arising from right subclavian artery.
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Figure 4 Transcatheter approaches of stent implantation. (a and b) pre- and post-stent implantation in tetralogy of Fallot-pulmonary atresia. A 6-F Guiding Judkin's Right catheter was passed through ventricular septal defect and anterogradely into ascending aorta with guide wire securely anchored in distal pulmonary artery; (c) normal ductus morphology in tricuspid atresia; (d) post-stent implantation by retrograde transarterial approach.
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Figure 5 Stent stenosis. (a) In-stent stenosis: layer of neointimal proliferation between white arrows; (b) stenosis of unstented segment of a long vertical ductus arising from left subclavian artery; (c) an additional stent was implanted over the stenosed and unstented segment of the ductus.
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Figure 6 Outcome of 51 patients who underwent successful stent implantation. BT = Blalock-Taussig; LPA = left pulmonary artery; PA = pulmonary artery; PDA = patent ductus arteriosus; RPA = right pulmonary artery.
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Figure 7 Freedom from reintervention. The reintervention included catheter-related procedure (balloon dilation of stent and restenting) and Blalock-Taussig shunt surgery.
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