No CrossRef data available.
Article contents
Ductal stenting for retraining the left ventricle in patients with transposition of great arteries with intact ventricular septum: a single-centre experience
Published online by Cambridge University Press: 17 October 2024
Abstract
Introduction
Ductal stenting in late presenters with transposition of great arteries with intact ventricular septum retrains the left ventricle before arterial switch operation. However, the experience is limited for its efficacy and safety. This study aims to highlight the efficacy and safety of ductal stenting for retraining the left ventricle.
Methods:
Eight children with transposition of great arteries-intact ventricular septum and regressed left ventricle underwent ductal stenting. Serial echocardiographic measurements of left ventricle shape, mass, volume, free wall thickness, and function were done, and arterial switch operation was performed once the left ventricle was adequately prepared. Post-operative outcome in terms of duration of mechanical ventilation, ICU stay, and improvement in left ventricle function were monitored.
Results:
The procedure was successful in all patients. Babies were divided into two groups on basis of age at ductal stenting (group 1 age less than 90 days and group 2 age more than 90 days) and were evaluated for the degree of left ventricle retraining as evidenced by echocardiographic parameters and post-operative variables. The left ventricle posterior wall thickness and mass index after ductal stenting increased significantly in both the groups. Postoperatively, one baby of group two expired after seven days due to severe left ventricle dysfunction. Rest babies had an uneventful post-operative ICU stay with no statistical difference in the duration of invasive mechanical ventilation or ICU stay. On six-month follow-up, all surviving babies were doing well with normal left ventricle function.
Conclusion:
Ductal stenting is a good alternative measure as compared to surgical procedures for left ventricle retraining in transposition of great arteries with regressed left ventricle.
Keywords
Information
- Type
- Original Article
- Information
- Copyright
- © The Author(s), 2024. Published by Cambridge University Press
References
Nicholas, TK, Blackstone, EH, Doty, DB, Hanley, FL, Karp, RB. Kirklin/Baratt-Boyes Cardiac Surgery. Churchill Livingstone, Philadelphia, 2003, pp. 1438–1507.Google Scholar
Kramer, HH, Scheewe, J, Fischer, G, et al. Long term follow-up of left ventricular performance and size of the great arteries before and after one- and two-stage arterial switch operation of simple transposition, of left ventricular performance and size of the great arteries before and after one- and two-stage arterial switch operation of simple transposition. Eur J Cardiothorac Surg 2003; 24: 898–905.CrossRefGoogle ScholarPubMed
Sharma, R, Bhan, A, Choudhary, SK, et al. Ten-year experience with the arterial switch operation, experience with the arterial switch operation. Indian Heart J 2002; 54: 681–00.Google ScholarPubMed
Wernovsky, G, Giglia, TM, Jonas, RA, Mone, SM, Colan, SD, Wessel, DL. Course in the intensive care unit after preparatory pulmonary artery banding and aortopulmonary shunt placement for transposition of the great arteries with low left ventricular pressure. Circulation 1992; 86:, 133–139.Google ScholarPubMed
Kothari, SS, Ramakrishnan, S, Senguttuvan, NB, Gupta, SK, Bisoi, AK. Ductal recnalization and stenting of late presenters with TGA intact ventricular septum. Ann Pediatr Cardiol 2011; 4: 135–138.CrossRefGoogle ScholarPubMed
Soo, KW, Leong, MC, Khalid, F. Recanalisation of the closed ductus arteriosus in a critically ill infant with transposition of the great arteries. Cardiol Young 2016; 26: 371–374.CrossRefGoogle Scholar
Lang, RM, Badano, LP, Mor-Avi, V, et al. Recommendation for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2015; 16: 233–270.CrossRefGoogle ScholarPubMed
Gopalakrishnan, A, Sasidharan, B, Krishnamoorthy, KM, et al. Left ventricular regression after balloon atrial septostomy in d-transposition of the great arteries. Eur J Cardiothorac Surg 2016; 50: 1096–1101.CrossRefGoogle ScholarPubMed
Leong, MC, Ahmed Alhassan, AA, Sivalingam, S, Alwi, M. Ductal stenting to retrain the involuted left ventricle in d-transposition of the great arteries. Ann Thorac Surg 2019; 108: 813–819.CrossRefGoogle ScholarPubMed
Nicholas, TK, Blackstone, EH, Hanley, FL, Kirklin, JK. Complete transposition of the great arteries. In Kirklin/Baratt-Boyes Cardiac Surgery, 4th. Churchill Livingstone, Philadelphia, 2012: pp1855–1930.Google Scholar
Ma, K, Hua, Z, Yang, K, et al. Arterial switch for transposed great vessels with intact ventricular septum beyond one month of age. Ann Thorac Surg 2014; 97: 189–195.CrossRefGoogle ScholarPubMed
Bisoi, AK, Ahmed, T, Malankar, DP, et al. Midterm outcome of primary arterial switch operation beyond six weeks of life in children with transposition of great arteries and intact ventricular septum. World J Pediatr Congenit Heart Surg 2014; 5: 219–225.CrossRefGoogle ScholarPubMed
Kang, N, de Leval, MR, Elliott, M, et al. Extending the boundaries of the primary arterial switch operation in patients with transposition of the great arteries and intact ventricular septum. Circulation 2004; 110: 123–127.CrossRefGoogle ScholarPubMed
Nathan, M. Late arterial switch operation for transposition with intact septum. World J Pediatr Congenit Heart Surg 2014; 5:226–228.CrossRefGoogle ScholarPubMed
Cain, MT, Cao, I, Ghanayem, YS, et al. Transposition of the great arteries-outcomes and time interval of early neonatal repair. World J Pediatr Congenital Heart Surg 2014; 5: 214–247.CrossRefGoogle ScholarPubMed
Yacoub, MH, Radley-Smith, R, Maclaurin, R. Two-stage operation for anatomical correction of transposition of the great arteries with intact interventricular septum. Lancet 1977; 1: 1275–1278.CrossRefGoogle ScholarPubMed
Jonas, RA, Giglia, T, Sanders, SP, et al. Rapid, two-stage arterial switch for transposition of the great arteries and intact ventricular septum beyond the neonatal period. Circulation 1989; 80: 203–208.Google ScholarPubMed
Iyer, KS, Sharma, R, Kumar, K, et al. Serial echocardiography for decision making in rapid two-stage arterial switch operation. Ann Thorac Surg 1995; 60: 658–664.CrossRefGoogle ScholarPubMed
Sivakumar, K, Francis, E, Krishnan, P, et al. Ductal stenting retrains the left ventricle in transposition of great arteries with intact ventricular septum. J Thorac Cardiovasc Surg 2006; 132: 1081–1086.CrossRefGoogle ScholarPubMed
Mumtaz, ZA, Sivakumar, K. Acute intraprocedural thrombosis during an arterial ductal stenting successfully managed by eptifibatide. Cardiol Young 2022; 32: 665–667.CrossRefGoogle ScholarPubMed
Alwi, M. Stenting the ductus arteriosus: case selection, technique and possible complications. Ann Pediatr Cardiol 2008; 1: 38–45.CrossRefGoogle ScholarPubMed
Banerji et al. supplementary material 1
Banerji et al. supplementary material
File
16 MB
Banerji et al. supplementary material 2
Banerji et al. supplementary material
File
17.7 MB
Banerji et al. supplementary material 3
Banerji et al. supplementary material
File
12.3 MB
Banerji et al. supplementary material 4
Banerji et al. supplementary material
File
503.9 KB
Banerji et al. supplementary material 5
Banerji et al. supplementary material
File
512.8 KB
- 2
- Cited by