Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2014 , Vol 5, Issue 2
Stent Implantation To Right Sided Cardiovascular Structures
Murat Şahin1, Işıl Yıldırım2, Tevfik Karagöz2, Süheyla Özkutlu2, Sema Özer2, Dursun Alehan2, Alpay Çeliker3
1International Hospital, Pediatrik Kardiyoloji, İstanbul, Türkiye
2Hacettepe Üniversitesi Tıp Fakültesi, Pediatrik Kardiyoloji, Ankara, Türkiye
3Acıbadem Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları, İstanbul, Türkiye
Objectives: Stenosis of native arteries and of surgically placed conduits is a major problem. Patients that underwent stent implantation to right sided vascular structures were retrospectively analyzed.

Methods: Seventeen patients underwent 18 stent implantations between 1999 and 2010. All of the patients' age, history of previous surgeries, anatomy of the stenotic segment and the pressure gradient were recorded. Balloon-expandable stents were implanted into pulmonary artery branches, between right ventricle and pulmonary artery, into Fontan circulation and to right ventricle outflow tract. Patients were classified into two groups clinically: those without cyanosis (n = 13) and those with cyanosis (n = 4).

Results: Median age and weight of the patients' were 5 years (5 days-17 years) and 18 kilograms (3.2-65) respectively. Median systolic pressure gradient (mmHg) decreased to 73 from 103 between right ventricle and pulmonary artery; and to 1 from 8 in pulmonary artery branches and Fontan circulation. Vessel diameters increased 2.4 times in acyanotic group. Median oxygen saturation increased from 45 to 80, and satisfactory clinical improvement was observed in cyanotic group. Four patients required surgical interventions in acyanotic group, one for stent fracture and three for restenosis.

Conclusion: Stent implantation in selected cases is a safe and effective alternative to surgery. Redilation or subsequent surgical interventions due to residual stenosis, somatic growth or neointimal proliferation may be required. In patients with cyanotic congenital heart disease who have a duct dependent pulmonary circulation with low chance of surgery use of coronary stents may be life-saving. Keywords : endovascular stent, child, transcatheter, right sided cardiovascular