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Transcatheter stenting of the right ventricular outflow tract augments pulmonary arterial growth in symptomatic infants with right ventricular outflow tract obstruction and hypercyanotic spells

Published online by Cambridge University Press:  04 March 2016

Eimear McGovern ,
Conall T. Morgan ,
Paul Oslizlok ,
Damien Kenny ,
Kevin P. Walsh  and
Colin J. McMahon
Eimear McGovern
Affiliation:
Department of Paediatric Cardiology, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
Conall T. Morgan
Affiliation:
Department of Paediatric Cardiology, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
Paul Oslizlok
Affiliation:
Department of Paediatric Cardiology, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
Damien Kenny
Affiliation:
Department of Paediatric Cardiology, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
Kevin P. Walsh
Affiliation:
Department of Paediatric Cardiology, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
Colin J. McMahon*
Affiliation:
Department of Paediatric Cardiology, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
*
Correspondence to: Dr C. J. McMahon, FRCPI Cardiac Department, Our Lady’s Children’s Hospital, Crumlin, Dublin 12, Ireland. Tel: +01 4096160; Fax: +01 4096181; E-mail: cmcmahon992004@yahoo.com
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Abstract

We retrospectively reviewed all the children with right ventricular outflow tract obstruction, hypoplastic pulmonary annulus, and pulmonary arteries who underwent stenting of the right ventricular outflow tract for hypercyanotic spells at our institution between January, 2008 and December, 2013; nine patients who underwent cardiac catheterisation at a median age of 39 days (range 12–60 days) and weight of 3.6 kg (range 2.6–4.3 kg) were identified. The median number of stents placed was one stent (range 1–4). The median oxygen saturation increased from 60% to 96%. The median right pulmonary artery size increased from 3.3 to 5.5 mm (−2.68 to −0.92 Z-score), and the median left pulmonary artery size increased from 3.4 to 5.5 mm (−1.93 to 0 Z-scores). Among all, one patient developed transient pulmonary haemorrhage, and one patient had pericardial tamponade requiring drainage. Complete repair of tetralogy of Fallot +/− atrioventricular septal defect or double-outlet right ventricle was achieved in all nine patients. Transcatheter stent alleviation of the right ventricular outflow tract obstruction resolves hypercyanotic spells and allows reasonable growth of the pulmonary arteries to facilitate successful surgical repair. This represents a viable alternative to placement of a systemic-to-pulmonary artery shunt, particularly in small neonates.

Keywords

Hypercyanotic spelltetralogy of Fallotright ventricular outflow tractstent
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 7 , October 2016 , pp. 1260 - 1265
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Copyright
© Cambridge University Press 2016 

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