Comparison of Patent Ductus Arteriosus Stent and Blalock–Taussig Shunt as Palliation for Neonates with Sole Source Ductal-Dependent Pulmonary Blood Flow: Results from the Congenital Catheterization Research Collaborative

2021 ◽  
Author(s):  
Holly Bauser-Heaton ◽  
Athar M. Qureshi ◽  
Bryan H. Goldstein ◽  
Andrew C. Glatz ◽  
R. Allen Ligon ◽  
...  
Keyword(s):  
Blood Flow ◽  
Patent Ductus Arteriosus ◽  
Pulmonary Blood Flow ◽  
Ductus Arteriosus ◽  
Sole Source ◽  
Blalock Taussig Shunt ◽  
Patent Ductus

scholarly journals Patent Ductus Arteriosus Stenting for All Ductal-Dependent Cyanotic Infants

2021 ◽  
Vol 14 (3) ◽  
Author(s):  
Kanishka Ratnayaka ◽  
Stephen J. Nageotte ◽  
John W. Moore ◽  
Peter W. Guyon ◽  
Krishna Bhandari ◽  
...  
Keyword(s):  
Blood Flow ◽  
Length Of Stay ◽  
Patent Ductus Arteriosus ◽  
Pulmonary Blood Flow ◽  
Ductus Arteriosus ◽  
Pulmonary Arteries ◽  
Practice Change ◽  
Almost All ◽  
Blalock Taussig Shunt ◽  
Patent Ductus

Background: Ductal-dependent cyanotic newborns require a secure source of pulmonary blood flow. There has been a recent migration to selective ductal (patent ductus arteriosus [PDA]) stenting for some of these children. Universal (nonselective) ductal stenting for all infants with ductal-dependent pulmonary blood flow is controversial. We examine outcomes from a single center with this practice change. Methods: We compare outcomes of all ductal-dependent pulmonary blood flow infants (2013–2020 [January–June]) in the following treatment eras: Era 1 (selective PDA stenting; 2013–2017) or Era 2 (universal PDA stenting; 2018–2020 [January–June]). Results: Eighty-eight patients (Blalock-Taussig shunt, n=41; PDA stent, n=47) met inclusion criteria. In Era 1, most received Blalock-Taussig shunt (62% [41/66]). In Era 2, all received PDA stents (100% [22/22]). There were more females in Era 2, but otherwise no demographic differences between eras. There were no differences in mortality, treatment failures, complications, or reinterventions between eras. Postprocedure length of stay was shorter in Era 2 (8 versus 22 days, P =0.02). There were less surgical revisions for PDA stent patients (2% versus 20%, P =0.02). Postprocedure recovery surrogate end points favored Era 2 and PDA stenting. Additional analysis revealed PDA stent (compared with Blalock-Taussig shunt) patients had shorter post-procedure (10 versus 29 days, P ≤0.001) length of stay and more symmetrical branch pulmonary arteries (0.9 versus 0.7, P =0.001) at subsequent surgery. Conclusions: PDA stenting for almost all ductal dependent cyanotic newborns can be safe and effective and may have lower morbidity than selective PDA stenting.

scholarly journals Comparison Between Patent Ductus Arteriosus Stent and Modified Blalock-Taussig Shunt as Palliation for Infants With Ductal-Dependent Pulmonary Blood Flow

Circulation ◽  
2018 ◽  
Vol 137 (6) ◽  
pp. 589-601 ◽  
Author(s):  
Andrew C. Glatz ◽  
Christopher J. Petit ◽  
Bryan H. Goldstein ◽  
Michael S. Kelleman ◽  
Courtney E. McCracken ◽  
...  
Keyword(s):  
Blood Flow ◽  
Patent Ductus Arteriosus ◽  
Pulmonary Blood Flow ◽  
Ductus Arteriosus ◽  
Blalock Taussig Shunt ◽  
Patent Ductus

EFFECT OF THE PATENT DUCTUS ARTERIOSUS ON THE PULMONARY BLOOD FLOW, BLOOD VOLUME, HEART RATE, BLOOD PRESSURE, ARTERIAL BLOOD GASES AND pH

PEDIATRICS ◽  
1950 ◽  
Vol 6 (4) ◽  
pp. 557-572
Author(s):  
DONALD E. CASSELS ◽  
MINERVA MORSE ◽  
W. E. ADAMS
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Patent Ductus Arteriosus ◽  
Blood Volume ◽  
Pulmonary Blood Flow ◽  
Ductus Arteriosus ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Arterial Blood ◽  
Patent Ductus

The effect of the patent ductus arteriosus on the circulation and on the arterial blood gases and pHs has been studied. The pulmonary blood flow diminished 19.6 to 61.8% following ligation in 12 cases examined. The blood volume diminished following closure of the ductus in most cases. Likewise, the heart rate lessened and the pulse pressure was lower after surgery. Arterial oxygen saturation was low preoperatively in some cases and in most instances postoperatively, and this low value sometimes persisted. Some aspects of the data presented have been discussed in detail.

Patent Ductus Arteriosus Banding for Circular Shunting After Pulmonary Valvuloplasty

2016 ◽  
Vol 8 (5) ◽  
pp. 643-645 ◽  
Author(s):  
Carles Bautista-Rodriguez ◽  
Javier Rodriguez-Fanjul ◽  
Julio Moreno Hernando ◽  
Javier Mayol ◽  
Jose Maria Caffarena-Calvar
Keyword(s):  
Blood Flow ◽  
Patent Ductus Arteriosus ◽  
Pulmonary Blood Flow ◽  
Pulmonary Valve ◽  
Ductus Arteriosus ◽  
Pulmonary Stenosis ◽  
Pulmonary Regurgitation ◽  
Increased Blood Flow ◽  
Critical Pulmonary Stenosis ◽  
Patent Ductus

We report two cases of newborns with critical pulmonary stenosis having intact ventricular septum, who underwent pulmonary valve balloon valvuloplasty followed by banding of a patent ductus arteriosus. Transcatheter pulmonary valvuloplasty was performed one week after delivery. Following the procedure, both developed “circular shunting” as a consequence of left-to-right ductal flow and pulmonary regurgitation. This in turn caused increased blood flow into a dysfunctional right ventricle and low systemic cardiac output syndrome. The PDA banding was performed urgently as a rescue measure in order to restore systemic flow while still maintaining some duct-dependent pulmonary blood flow. This approach resolved the circular shunting. Outcome was favorable in both the patients.

Echocardiographic and Radionuclide Pulmonary Blood Flow Patterns After Transcatheter Closure of Patent Ductus Arteriosus

Circulation ◽  
1996 ◽  
Vol 94 (2) ◽  
pp. 126-129 ◽  
Author(s):  
Hugues Dessy ◽  
Joris P.S. Hermus ◽  
Freek van den Heuvel ◽  
H.Y. Oei ◽  
Eric P. Krenning ◽  
...  
Keyword(s):  
Blood Flow ◽  
Patent Ductus Arteriosus ◽  
Pulmonary Blood Flow ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Flow Patterns ◽  
Blood Flow Patterns ◽  
Patent Ductus

Pre-procedural CT imaging aids neonatal PDA stenting for ductal-dependent pulmonary blood flow with reduction in overall procedural morbidity

2021 ◽  
pp. 1-6
Author(s):  
Yousef Arar ◽  
V. Vivian Dimas ◽  
Alan W. Nugent ◽  
Tarique Hussain ◽  
Nima Kasraie ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Blood Flow ◽  
Patent Ductus Arteriosus ◽  
Pulmonary Blood Flow ◽  
Ductus Arteriosus ◽  
Computed Tomography Imaging ◽  
Radiation Burden ◽  
Tomography Imaging ◽  
Procedural Time ◽  
Patent Ductus

Abstract Patent ductus arteriosus stenting for ductal-dependent pulmonary blood flow is a technically challenging neonatal procedure to maintain a stable pulmonary circulation. Pre-procedural computed tomography imaging aids in outlining ductal origin, insertion, size, course and curvature. Computed tomography imaging may add value to procedural outcomes and reduce overall procedural morbidity in neonatal patent ductus arteriosus stenting. We conducted a single centre retrospective chart review of neonates with ductal-dependent pulmonary blood flow who underwent patent ductus arteriosus stenting between January 1, 2014 and June 31, 2020. We compared patients variables between patients who underwent pre-procedural computed tomography imaging to those who did not. A total of 64 patients were referred for patent ductus arteriosus stenting with 33 (52%) obtaining pre-procedural computed tomography imaging. Average age [19 days; range 1–242 days (p = 0.85)] and weight [3.3 kg (range 2.2–6.0 kg; p = 0.19)] was not significantly different between the groups. A diagnosis of pulmonary atresia was made in 42 out of 64 (66%) patients prior to patent ductus arteriosus stenting. The cohort with pre-intervention computed tomography imaging had a significant reduction in the total number of access sites (1.2 versus 1.5; p = 0.03), contrast needed (5.9 versus 8.2 ml/kg; p = 0.008), fluoroscopy (20.7 versus 38.8 minutes; p = 0.02) and procedural time (83.4–128.4 minutes; p = 0.002) for the intervention. There was no significant difference in radiation burden between the groups (p = 0.35). Pre-procedural computed tomography imaging adds value by aiding interventional planning for neonatal patent ductus arteriosus stenting. A statistically significant reduction in the number of access sites, contrast exposure, as well as fluoroscopic and procedural time was noted without significantly increasing the cumulative radiation burden.

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