Long-term outcomes of intraoperative pulmonary artery stent placement for congenital heart disease

Michael J. Angtuaco, Ritu Sachdeva, Robert D.B. Jaquiss, W. Robert Morrow, Jeffrey M. Gossett, Eudice Fontenot, Paul M. Seib

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objective:Our objective was to examine long-term outcomes of intraoperative pulmonary artery stents and determine risk factors for reintervention Background:Short-term outcomes of intraoperative pulmonary artery stents have been reported previously. However, long-term results are unknown. Methods: We conducted a retrospective review of patients who underwent intraoperative pulmonary artery stent placement for branch pulmonary artery stenosis. Results: Ninety-six stents were implanted intraoperatively in 67 patients. Twenty-seven patients received two or more stents at initial intervention. Median patient age at initial stent placement was 1.8 years. Median post-inflation diameter was 8 mm. At a mean follow-up of 7.6 ± 4.5 years, 49% of stents required reintervention (balloon angioplasty at catheterization in 28 patients and surgical revision in 19 patients). Actuarial freedom from reintervention at 2, 5, and 10 years was 68%, 49%, and 40%, respectively. In univariate analysis of time to first reintervention, age at implantation < 2 yrs (P < 0.0009) and initial post-inflation stent diameter < 10 mm (P < 0.0002) were associated with risk for reintervention. Multivariable Cox regression analysis showed age < 2 years (P < 0.005) and diagnosis of tetralogy of Fallot (p < 0.002) or truncus arteriosus (P < 0.007) to be significant risk factors for reintervention. Conclusion: Intraoperative placement of stents in the pulmonary arteries is an alternative to surgical angioplasty, but is associated with a high incidence of reintervention. Age < 2 years and the diagnosis of tetralogy of Fallot or truncus arteriosus are risk factors for reintervention.

Original languageEnglish (US)
Pages (from-to)395-399
Number of pages5
JournalCatheterization and Cardiovascular Interventions
Volume77
Issue number3
DOIs
StatePublished - Feb 15 2011

Fingerprint

Pulmonary Artery
Stents
Heart Diseases
Truncus Arteriosus
Tetralogy of Fallot
Economic Inflation
Balloon Angioplasty
Reoperation
Angioplasty
Catheterization
Regression Analysis
Incidence

Keywords

  • branch pulmonary artery stenosis
  • intraoperative stent
  • outcomes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Long-term outcomes of intraoperative pulmonary artery stent placement for congenital heart disease. / Angtuaco, Michael J.; Sachdeva, Ritu; Jaquiss, Robert D.B.; Morrow, W. Robert; Gossett, Jeffrey M.; Fontenot, Eudice; Seib, Paul M.

In: Catheterization and Cardiovascular Interventions, Vol. 77, No. 3, 15.02.2011, p. 395-399.

Research output: Contribution to journalArticle

Angtuaco, Michael J. ; Sachdeva, Ritu ; Jaquiss, Robert D.B. ; Morrow, W. Robert ; Gossett, Jeffrey M. ; Fontenot, Eudice ; Seib, Paul M. / Long-term outcomes of intraoperative pulmonary artery stent placement for congenital heart disease. In: Catheterization and Cardiovascular Interventions. 2011 ; Vol. 77, No. 3. pp. 395-399.
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AB - Objective:Our objective was to examine long-term outcomes of intraoperative pulmonary artery stents and determine risk factors for reintervention Background:Short-term outcomes of intraoperative pulmonary artery stents have been reported previously. However, long-term results are unknown. Methods: We conducted a retrospective review of patients who underwent intraoperative pulmonary artery stent placement for branch pulmonary artery stenosis. Results: Ninety-six stents were implanted intraoperatively in 67 patients. Twenty-seven patients received two or more stents at initial intervention. Median patient age at initial stent placement was 1.8 years. Median post-inflation diameter was 8 mm. At a mean follow-up of 7.6 ± 4.5 years, 49% of stents required reintervention (balloon angioplasty at catheterization in 28 patients and surgical revision in 19 patients). Actuarial freedom from reintervention at 2, 5, and 10 years was 68%, 49%, and 40%, respectively. In univariate analysis of time to first reintervention, age at implantation < 2 yrs (P < 0.0009) and initial post-inflation stent diameter < 10 mm (P < 0.0002) were associated with risk for reintervention. Multivariable Cox regression analysis showed age < 2 years (P < 0.005) and diagnosis of tetralogy of Fallot (p < 0.002) or truncus arteriosus (P < 0.007) to be significant risk factors for reintervention. Conclusion: Intraoperative placement of stents in the pulmonary arteries is an alternative to surgical angioplasty, but is associated with a high incidence of reintervention. Age < 2 years and the diagnosis of tetralogy of Fallot or truncus arteriosus are risk factors for reintervention.

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