Page 133 - Journal of Structural Heart Disease Volume 5, Issue 4

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Meeting Abstracts
the success of this procedure. Further study in larger popu- lation and longer follow up period to determine the strate- gic approach for this group of patients is warranted.
176. LONG-TERM OUTCOMES AND REINTERVENTIONS AFTER PULMONARY ARTERY STENT IMPLANTATION IN INFANTS AND SMALL CHILDREN (LESS THAN 12 KG) Stephen Nageotte1, Patrick Sullivan2, Sagar Pathak3, Howaida El-Said1, John Moore1, Frank Ing4
1Rady Children's Hospital, San Diego, USA. 2Children's Hospital Los Angeles, Los Angeles, USA. 3UCSD, San Diego, USA. 4UC Davis Children's Hospital, Davis, USA
Background: Use of stents to treat branch pulmonary artery (BPA) stenosis is the standard of care. However, long- term outcomes data after BPA stenting in infants and small children are scarce.
Methods: Pts ≤12kg who underwent PA stenting at a sin- gle institution 10/1997-6/2006 were included in a retro- spective review.
Results: 64 pts were initially identified, however, 8 were lost to follow-up after initial catheterization. The remain- ing 56 pts with a mean weight and age of 8.1±2.4kg and 13.2±8.4months respectively underwent implantation of 74 stents, with 18 pts undergoing bilateral stenting. 12 stents were placed intraoperatively. Table 1 summarizes the initial pre and post and final cath data at mean follow-up duration of 10.2yrs. Patients on average gained 25.1kg over 8.1yrs and minimum stented diameters increased from 3.2 to 10.2mm.
Stents underwent a median of 2 reinterventions (range 0-6). Median times to 1st, 2nd, and 3rd reinterventions were 1.6yrs (n=68; IQR: 0.6-3.2yrs), 2.4yrs (n=44; IQR: 0.8-4.9yrs), and 2.8yrs (n=23; IQR: 1.3-5.3yrs). There were 2 major complications at initial intervention: vessel tear during an intraoperative deployment requiring patch repair (1) and entrapment of a dilator tip in a stent (used in a novel front-loading technique) requiring surgical removal at the time of RV-PA conduit replacement. No major complica- tions occurred at reintervention. 18 vessels were re-stented at a follow-up catheterization due to adjacent stenosis. In
176. Table 1.
Initial Catheterization- pre stent measurements
post measurements
Final Cath**
(mean FU: 10.2±6.8yrs)
8.1±2.4 33.2±21
1.1±0.7 9.2±5.5
3.2±1.3
7.2±1.6 10.2±2.3
-3.3±1.1
0.3±1.1 -0.3±1.1
33±15
10±10 10±8
71±19
52±16 50±20
Weight (kg)
Age (years)
Minimal BPA diameter (mm)
BPA diameter z-score
BPA pressure gradient (mmHg)*
RV/SBP (%)*
* Patients with 2-ventricle physiology (N=46) ** N=74 stents
176. Table 2.
Initial Catheterization- initial measurements
Initial Catheterization- final measurements
Final Cath**
(mean FU duration: 12.7 yrs)
8.6±2.0
47.3±16
1.2±0.6
13.9±3.0
3.4±1.1 7.4±1.3 11.3±1.9
-3.1±1.0 0.3±0.9 -0.6±0.9
33±14 11±11 11.8±7
75±19 50±11 46±11
Weight (kg)
Age (years)
Minimal BPA diameter (mm)
BPA diameter z-score
BPA pressure gradient (mmHg)*
RV/SBP (%)*
* Patients with 2-ventricle physiology (N=18) ** N=37 stents
Hijazi, Z
22nd Annual PICS/AICS Meeting