Ductal recanalization and stenting for late presenters with TGA intact ventricular septum
Introduction: The ideal management strategy for patients presenting late with transposition of great arteries (TGA), intact ventricular septum (IVS), and regressed left ventricle (LV) is not clear. Primary switch, two-stage switch, and Senning operation are the options. Left ventricular retraining p...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2011-01-01
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| Series: | Annals of Pediatric Cardiology |
| Subjects: | |
| Online Access: | http://www.annalspc.com/article.asp?issn=0974-2069;year=2011;volume=4;issue=2;spage=135;epage=138;aulast=Kothari |
| _version_ | 1828316366381252608 |
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| author | Shyam S Kothari Sivasubramanian Ramakrishnan Nagendra Boopathy Senguttuvan Saurabh Kumar Gupta Akshay K Bisoi |
| author_facet | Shyam S Kothari Sivasubramanian Ramakrishnan Nagendra Boopathy Senguttuvan Saurabh Kumar Gupta Akshay K Bisoi |
| author_sort | Shyam S Kothari |
| collection | DOAJ |
| description | Introduction: The ideal management strategy for patients presenting late with transposition of great arteries (TGA), intact ventricular septum (IVS), and regressed left ventricle (LV) is not clear. Primary switch, two-stage switch, and Senning operation are the options. Left ventricular retraining prior to arterial switch by ductal stenting may be effective, but the experience is very limited.
Methods: Five of six children aged 3-6 months with TGA-IVS and regressed LV underwent recanalization and transcatheter stenting of ductus arteriosus. The ductal stent was removed during arterial switch surgery.
Results: The procedure was successful in 5/6 patients. All the patients had totally occluded ductus and needed recanalization with coronary total occlusion hardware. The ductus was dilated and stented with coronary stents. In all the patients, there was significant luminal narrowing despite adequate stent placement and deployment. Two patients needed reintervention for abrupt closure of the stent. Ductal stenting resulted in left ventricular preparedness within 7-14 days. One patient died of progressive sepsis after 14 days of stenting, even though the LV was prepared. Four patients underwent successful uneventful arterial switch surgery. During surgery, it was observed that the mucosal folds of duct were protruding through the struts of the stent in one patient.
Conclusions: Ductal stenting is a good alternative strategy for left ventricular retraining in TGA with regressed LV even in patients with occluded ducts. |
| first_indexed | 2024-04-13T17:13:32Z |
| format | Article |
| id | doaj.art-1828d32cb9ad4e7ba5271a01b9464309 |
| institution | Directory Open Access Journal |
| issn | 0974-2069 |
| language | English |
| last_indexed | 2024-04-13T17:13:32Z |
| publishDate | 2011-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Pediatric Cardiology |
| spelling | doaj.art-1828d32cb9ad4e7ba5271a01b94643092022-12-22T02:38:12ZengWolters Kluwer Medknow PublicationsAnnals of Pediatric Cardiology0974-20692011-01-014213513810.4103/0974-2069.84651Ductal recanalization and stenting for late presenters with TGA intact ventricular septumShyam S KothariSivasubramanian RamakrishnanNagendra Boopathy SenguttuvanSaurabh Kumar GuptaAkshay K BisoiIntroduction: The ideal management strategy for patients presenting late with transposition of great arteries (TGA), intact ventricular septum (IVS), and regressed left ventricle (LV) is not clear. Primary switch, two-stage switch, and Senning operation are the options. Left ventricular retraining prior to arterial switch by ductal stenting may be effective, but the experience is very limited. Methods: Five of six children aged 3-6 months with TGA-IVS and regressed LV underwent recanalization and transcatheter stenting of ductus arteriosus. The ductal stent was removed during arterial switch surgery. Results: The procedure was successful in 5/6 patients. All the patients had totally occluded ductus and needed recanalization with coronary total occlusion hardware. The ductus was dilated and stented with coronary stents. In all the patients, there was significant luminal narrowing despite adequate stent placement and deployment. Two patients needed reintervention for abrupt closure of the stent. Ductal stenting resulted in left ventricular preparedness within 7-14 days. One patient died of progressive sepsis after 14 days of stenting, even though the LV was prepared. Four patients underwent successful uneventful arterial switch surgery. During surgery, it was observed that the mucosal folds of duct were protruding through the struts of the stent in one patient. Conclusions: Ductal stenting is a good alternative strategy for left ventricular retraining in TGA with regressed LV even in patients with occluded ducts.http://www.annalspc.com/article.asp?issn=0974-2069;year=2011;volume=4;issue=2;spage=135;epage=138;aulast=KothariArterial switch surgeryductal stentingtransposition of the great arteries |
| spellingShingle | Shyam S Kothari Sivasubramanian Ramakrishnan Nagendra Boopathy Senguttuvan Saurabh Kumar Gupta Akshay K Bisoi Ductal recanalization and stenting for late presenters with TGA intact ventricular septum Annals of Pediatric Cardiology Arterial switch surgery ductal stenting transposition of the great arteries |
| title | Ductal recanalization and stenting for late presenters with TGA intact ventricular septum |
| title_full | Ductal recanalization and stenting for late presenters with TGA intact ventricular septum |
| title_fullStr | Ductal recanalization and stenting for late presenters with TGA intact ventricular septum |
| title_full_unstemmed | Ductal recanalization and stenting for late presenters with TGA intact ventricular septum |
| title_short | Ductal recanalization and stenting for late presenters with TGA intact ventricular septum |
| title_sort | ductal recanalization and stenting for late presenters with tga intact ventricular septum |
| topic | Arterial switch surgery ductal stenting transposition of the great arteries |
| url | http://www.annalspc.com/article.asp?issn=0974-2069;year=2011;volume=4;issue=2;spage=135;epage=138;aulast=Kothari |
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