Early and Long-Term Clinical Outcomes of Ductal Stenting Versus Surgical Aortopulmonary Shunt Among Young Infants with Duct-Dependent Pulmonary Circulation

AbstractSurgical aortopulmonary shunting (SAPS) and ductal stenting (DS) are the main palliations in infants with cyanotic congenital heart diseases (CHD). We aimed to study the safety and efficacy of DS and to compare it with SAPS as a palliative procedure in infants with CHD and duct-dependent pulmonary circulation. Retrospective institutional clinical data review of consecutive infants aged  <  3 months who underwent DS or SAPS over 5 years. The primary outcome was procedural success which was defined as event-free survival (mortality, need for re-intervention, procedural failure) at 30 days post-procedure. The secondary outcome was defined by a composite of death, major adverse card iovascular events, or need for re-intervention at 6 months and on long-term follow-up. We included 102 infants (DS,n = 53 and SAPS,n = 49). The median age at DS and SAPS was 4 days (IQR 2.0–8.5) and 8 days (IQR 4.0–39.0), respectively. The median weight at intervention was 3.0 kg (IQR 3.0–3.0) and 3.0 kg (IQR 2.5–3.0) in the two respective arms. Tetralogy of Fallot with pulmonary atresia was the most common indic ation for DS and SAPS. The 30-day mortality was significantly higher in SAPS group as compared with DS group (p <  0.05). However, 30-day major adverse cardiac events (MACE) rates were similar in both groups (p = 0.29). DS was associated with shorter duration of mechanical ventilation, duration of stay in the intensive care and hospital stay t...
Source: Pediatric Cardiology - Category: Cardiology Source Type: research