TY - JOUR
T1 - Long-term outcomes of intraoperative pulmonary artery stent placement for congenital heart disease
AU - Angtuaco, Michael J.
AU - Sachdeva, Ritu
AU - Jaquiss, Robert D.B.
AU - Morrow, W. Robert
AU - Gossett, Jeffrey M.
AU - Fontenot, Eudice
AU - Seib, Paul M.
PY - 2011/2/15
Y1 - 2011/2/15
N2 - Objective:Our objective was to examine long-term outcomes of intraoperative pulmonary artery stents and determine risk factors for reintervention Background:Short-term outcomes of intraoperative pulmonary artery stents have been reported previously. However, long-term results are unknown. Methods: We conducted a retrospective review of patients who underwent intraoperative pulmonary artery stent placement for branch pulmonary artery stenosis. Results: Ninety-six stents were implanted intraoperatively in 67 patients. Twenty-seven patients received two or more stents at initial intervention. Median patient age at initial stent placement was 1.8 years. Median post-inflation diameter was 8 mm. At a mean follow-up of 7.6 ± 4.5 years, 49% of stents required reintervention (balloon angioplasty at catheterization in 28 patients and surgical revision in 19 patients). Actuarial freedom from reintervention at 2, 5, and 10 years was 68%, 49%, and 40%, respectively. In univariate analysis of time to first reintervention, age at implantation < 2 yrs (P < 0.0009) and initial post-inflation stent diameter < 10 mm (P < 0.0002) were associated with risk for reintervention. Multivariable Cox regression analysis showed age < 2 years (P < 0.005) and diagnosis of tetralogy of Fallot (p < 0.002) or truncus arteriosus (P < 0.007) to be significant risk factors for reintervention. Conclusion: Intraoperative placement of stents in the pulmonary arteries is an alternative to surgical angioplasty, but is associated with a high incidence of reintervention. Age < 2 years and the diagnosis of tetralogy of Fallot or truncus arteriosus are risk factors for reintervention.
AB - Objective:Our objective was to examine long-term outcomes of intraoperative pulmonary artery stents and determine risk factors for reintervention Background:Short-term outcomes of intraoperative pulmonary artery stents have been reported previously. However, long-term results are unknown. Methods: We conducted a retrospective review of patients who underwent intraoperative pulmonary artery stent placement for branch pulmonary artery stenosis. Results: Ninety-six stents were implanted intraoperatively in 67 patients. Twenty-seven patients received two or more stents at initial intervention. Median patient age at initial stent placement was 1.8 years. Median post-inflation diameter was 8 mm. At a mean follow-up of 7.6 ± 4.5 years, 49% of stents required reintervention (balloon angioplasty at catheterization in 28 patients and surgical revision in 19 patients). Actuarial freedom from reintervention at 2, 5, and 10 years was 68%, 49%, and 40%, respectively. In univariate analysis of time to first reintervention, age at implantation < 2 yrs (P < 0.0009) and initial post-inflation stent diameter < 10 mm (P < 0.0002) were associated with risk for reintervention. Multivariable Cox regression analysis showed age < 2 years (P < 0.005) and diagnosis of tetralogy of Fallot (p < 0.002) or truncus arteriosus (P < 0.007) to be significant risk factors for reintervention. Conclusion: Intraoperative placement of stents in the pulmonary arteries is an alternative to surgical angioplasty, but is associated with a high incidence of reintervention. Age < 2 years and the diagnosis of tetralogy of Fallot or truncus arteriosus are risk factors for reintervention.
KW - branch pulmonary artery stenosis
KW - intraoperative stent
KW - outcomes
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U2 - 10.1002/ccd.22797
DO - 10.1002/ccd.22797
M3 - Article
C2 - 20853358
AN - SCOPUS:79951862804
SN - 1522-1946
VL - 77
SP - 395
EP - 399
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 3
ER -