Duct Stenting in Duct-Dependent Systemic Blood Flow, Past, Present, and Future.

Duct stenting HLHS Hybrid approach Percutaneous stage 1 Potts-shunt Pulmonary arterial hypertension

Journal

Pediatric cardiology

ISSN: 1432-1971

Titre abrégé: Pediatr Cardiol

Pays: United States

ID NLM: 8003849

Informations de publication

Date de publication:
25 Apr 2024

Historique:

received: 19 12 2023

accepted: 04 04 2024

medline: 26 4 2024

pubmed: 26 4 2024

entrez: 25 4 2024

Statut: aheadofprint

Résumé

Arterial duct stenting, pioneered in the early 1990s for newborns with a duct-dependent pulmonary and systemic circulation, has evolved significantly over the past decades. This progressive technique has led to the development of novel therapeutic strategies, including the Hybrid approach introduced three decades ago, and more recently, a complete transcatheter approach for treating newborns with hypoplastic left heart syndrome (HLHS). Subsequently, the transcatheter method has been extended to bi-ventricular lesions and patients with pulmonary hypertension, establishing a reverse Potts-shunt pathophysiology. Considering current experiences, this review aims to assess the strengths, weaknesses, and complications associated with ductal stenting, which represents a critical component of these complex treatment strategies. Despite advancements, the mortality rate of Norwood and Hybrid stage-1 procedures has plateaued, underscoring the importance of enhancing the quality of life of affected patients as the primary therapeutic goal. The prerequisite is a gentle, almost atraumatic medicine, particularly during the newborn period. It is essential to recognize that both the Hybrid and total transcatheter approaches demand comparable experience to Norwood surgery. Successful outcomes hinge on much more than merely inserting a stent into the duct; they require meticulous attention to detail and comprehensive management strategies.

Identifiants

DOI: 10.1007/s00246-024-03492-y PMID: 38664298

pubmed: 38664298

doi: 10.1007/s00246-024-03492-y

pii: 10.1007/s00246-024-03492-y

doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

Informations de copyright

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