Stent Implantation to Maintain Patency of a Stenosed Blalock Taussig Shunt

2005 ◽  
Vol 13 (3) ◽  
pp. 274-276 ◽  
Author(s):  
Amjad Kouatli ◽  
Jameel Al-Ata ◽  
M Omar Galal ◽  
Muhammed A Amin ◽  
Arif Hussain
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Oxygen Saturation ◽  
Stent Implantation ◽  
Congenital Heart ◽  
Balloon Dilation ◽  
Complex Congenital Heart Disease ◽  
Blalock Taussig Shunt

A 14-year-old female with complex congenital heart disease underwent a left-sided classical Blalock Taussig (BT) shunt 15 days after birth. Ten years after the operation her oxygen saturation had decreased significantly. An angiography revealed a severely stenosed BT shunt. Balloon dilation including implantation of a 6 × 13 mm stent was performed successfully. Immediately after intervention, oxygen saturation rose from 55% to 80 84% in room air. Follow-up at a year and a half later showed the classical BT shunt was still patent.

scholarly journals Initial use of endothelial progenitor cells capturing stents in paediatric congenital heart disease

2013 ◽  
Vol 24 (5) ◽  
pp. 900-904 ◽  
Author(s):  
Nuno Cabanelas ◽  
José D. F. Martins ◽  
Fátima Pinto
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Stent Implantation ◽  
Congenital Heart ◽  
Ductus Arteriosus ◽  
Neointimal Hyperplasia ◽  
Complex Congenital Heart Disease ◽  
Endothelial Progenitor ◽  
Transcutaneous Oxygen

AbstractIntroductionStenosis, mediated by neointimal hyperplasia and thrombosis, is a major limiting factor in successful stent implantation. The introduction of a stent, coated in its endoluminal surface by antihuman CD34 antibodies with endothelial progenitor cell-capturing properties, opens the possibility of promoting a rapid and normal functioning coverage by endothelium and thus avoids both an excessive cell proliferation within stent and the need for long-term dual antiplatelet therapy. These stents, developed for adult coronary artery disease, have not yet been implanted in children or in those with congenital heart disease.Objective and methodsIn this paper, we describe the implantation of Genous®stents in three children with cyanotic congenital heart disease and obstructed systemic-to-pulmonary shunts. We describe the use of this stent and address its potential feasibility in paediatric congenital heart disease.ResultsTo maintain the patency of two modified Blalock–Taussig shunts and one ductus arteriosus, four Genous®stents were implanted in three infants with cyanotic heart disease. All procedures were immediately successful, with resolution of stenosis and improvement in transcutaneous oxygen saturation from 66% ± 3.6% to 92% ± 2.6%. In the follow-up, one stent had no occlusion; however, the remaining two had partial occlusion after 5 and 5.5 months, which were successfully managed with balloon dilatation preceding elective definitive surgical correction.ConclusionIn our preliminary experience, we demonstrated that Genous®stent implantation was feasible in infants with complex congenital heart disease. Additional studies with larger samples and longer follow-up are required to confirm the potential benefits of this technology in this clinical setting.

scholarly journals Stenting of modified Blalock–Taussig shunt in adult with palliated pulmonary atresia and ventricular septal defect: a case report

2019 ◽  
Vol 3 (4) ◽  
pp. 1-4
Author(s):  
Julia Illner ◽  
Holger Reinecke ◽  
Helmut Baumgartner ◽  
Gerrit Kaleschke
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Ventricular Septal Defect ◽  
Pulmonary Artery ◽  
Congenital Heart ◽  
Septal Defect ◽  
Pulmonary Atresia ◽  
Complex Congenital Heart Disease ◽  
Bare Metal

Abstract Background Adults with complex congenital heart disease palliated with systemic-to-pulmonary artery shunts have become rare and represent a particularly challenging patient group for the cardiologist. One of the complications and causes of severe clinical deterioration during long-term follow-up are progressive obstruction or total occlusion of the shunt. The risk for surgical intervention is frequently high and catheter intervention may be complicated by complex anatomy and shunt calcification. Case summary We report the case of a 47-year-old man with uncorrected (palliated) pulmonary atresia and ventricular septal defect who presented with progressive cyanosis (oxygen saturation 69%) and decreasing exercise capacity. Computed tomography revealed a totally occluded modified left Blalock–Taussig (BT) shunt and a severely stenosed central shunt (Waterston–Cooley) in a patient with confluent but hypoplastic pulmonary arteries and multiple major aortic pulmonary collaterals. Due to a high operative risk, an interventional, percutaneous approach was preferred to re-do surgery. From a radial access the calcified BT shunt could be crossed with a hydrophilic guidewire. Then, a rotational thrombectomy, balloon dilatation, and bare-metal stenting at the proximal and distal anastomoses were performed. Post-interventionally, peripheral oxygen saturation increased from 69% to 82%. Clopidogrel was administered for 1 month after bare-metal stenting. At 1-year follow-up, the BT shunt was still patent on echocardiography and exercise tolerance markedly improved. Discussion This case highlights the benefit of percutaneous rotational thrombectomy followed by stenting of chronically occluded systemic-to-pulmonary artery shunts for further palliation in adult patients with complex congenital heart disease not suitable for surgical repair.

Late follow-up of 1095 patients undergoing operation for complex congenital heart disease utilizing pulmonary ventricle to pulmonary artery conduits

2003 ◽  
Vol 75 (2) ◽  
pp. 399-411 ◽  
Author(s):  
Joseph A Dearani ◽  
Gordon K Danielson ◽  
Francisco J Puga ◽  
Hartzell V Schaff ◽  
Carole W Warnes ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulmonary Artery ◽  
Congenital Heart ◽  
Complex Congenital Heart Disease

Developmental Alterations of Cerebral Gray and White Matter in Children with Congenital Cyanotic Heart Disease

2018 ◽  
Vol 17 (05) ◽  
pp. 161-167
Author(s):  
Juan Leon-Wyss ◽  
Cynthia Rosario ◽  
Janet Toribio ◽  
Herwin Speckter ◽  
Bernd Foerster ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
White Matter ◽  
Oxygen Saturation ◽  
Congenital Heart ◽  
Diffusion Tensor ◽  
Cyanotic Congenital Heart Disease ◽  
Congenital Cyanotic Heart Disease ◽  
Diffusion Tensor Imaging Dti

AbstractThis article examines the relation between oxygen saturation and T2 star time in cyanotic congenital heart disease and its correlation to cerebral gray and white matter alterations. Magnetic resonance imaging was performed in 25 patients (mean age: 52.2 months) and 32 controls. Gray and white matter volumes, as well as fractional anisotropy and longitudinal diffusivity, were significantly reduced in patients. The reduction longitudinal diffusivity correlated to oxygen saturation and T2 star time of gray matter (p < 0.05). This diffusion tensor imaging (DTI) parameter was most affected in cyanotic congenital heart disease and because is the only parameter showing significant correlation to reduced oxygenation, it should be included more often in the follow-up of these patients over time.

scholarly journals Long-Term Follow-Up Shows Excellent Transmural Atrial Lead Performance in Patients With Complex Congenital Heart Disease

2014 ◽  
Vol 7 (4) ◽  
pp. 652-657 ◽  
Author(s):  
Matthew R. Williams ◽  
Suzanne M. Shepard ◽  
Nicole K. Boramanand ◽  
John J. Lamberti ◽  
James C. Perry
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Complex Congenital Heart Disease ◽  
Long Term Follow Up
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