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Long‐term outcomes of intraoperative pulmonary artery stent placement for congenital heart disease
Author(s) -
Angtuaco Michael J.,
Sachdeva Ritu,
Jaquiss Robert D.B.,
Morrow W. Robert,
Gossett Jeffrey M.,
Fontenot Eudice,
Seib Paul M.
Publication year - 2010
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.22797
Subject(s) - medicine , tetralogy of fallot , angioplasty , surgery , stent , left pulmonary artery , pulmonary artery , truncus arteriosus , stenosis , cardiology , univariate analysis , heart disease , radiology , multivariate analysis
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. © 2010 Wiley‐Liss, Inc.