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Pediatric Cardiology

, Volume 29, Issue 4, pp 842–845 | Cite as

Stenting of Bilateral Arterial Ducts in Complex Congenital Heart Disease

  • Giuseppe SantoroEmail author
  • Giuseppe Caianiello
  • Maria Giovanna Russo
  • Raffaele Calabrò
Case Report

Abstract

Bilateral arterial ducts serving nonconfluent pulmonary arteries is a very rare pattern of pulmonary blood flow in congenital heart disease with pulmonary atresia. In this setting, neonatal ductal closure might result in abrupt pulmonary hypoperfusion and life-threatening systemic hypoxia, thereby indicating emergent surgical palliation or repair. However, percutaneous arterial duct stenting might be an alternative to surgery, especially in high-risk patients. This article reports on two critical neonates with complex heart disease and discontinuous pulmonary arteries dependent on bilateral arterial ducts who successfully underwent transcatheter ductal stenting as first-step palliation toward lower-risk corrective surgery.

Keywords

Congenital heart disease Patent arterial duct Stent Cyanosis 

Supplementary material

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References

  1. 1.
    Barbero-Marcial M, Atik E, Baucia J, Pradel H, Macruz R, Jatene A (1988) Reconstruction of the stenotic or nonconfluent pulmonary arteries simultaneously with a Blalock-Taussig shunt. J Thorac Cardiovasc Surg 95:82–89PubMedGoogle Scholar
  2. 2.
    Formigari R, Vairo U, Santoro G, De Zorzi A, Marino B (1992) Prevalence of bilateral patent ductus arteriosus in patients with pulmonic atresia and asplenic syndrome. Am J Cardiol 70(13):1219–1220PubMedCrossRefGoogle Scholar
  3. 3.
    Freedom RM, Moes CA, Pelech A, et al. (1984) Bilateral ductus arteriosus (o remnant): an analysis of 27 patients. Am J Cardiol 53(7):884–891PubMedCrossRefGoogle Scholar
  4. 4.
    McElhinney DB, Reddy VM, Moore P, Hanley FL (1997) Bilateral branch pulmonary artery obstruction due to kinking at insertion sites of bilateral ductus arteriosus. Ann Thorac Surg 64:537–539PubMedCrossRefGoogle Scholar
  5. 5.
    Park IS, Kim YH, Ko JK (1997) Bilateral patent ductus arteriosus and non-confluent pulmonary arteries in neonates. Tex Heart Inst J 24(4):384–385PubMedGoogle Scholar
  6. 6.
    Peirone A, Mustafa MA, Dicke F, Freedom RM, Smallhorn J (2002) Echocardiographic evaluation, management and outcomes of bilateral arterial ducts and complex congenital heart disease: 16 years experience. Cardiol Young 12:272–277PubMedCrossRefGoogle Scholar
  7. 7.
    Peirone A, Lee KJ, Yoo SJ, Musewe N, Smallhorn J, Benson L (2003) Staged rehabilitation of ductal origin of the left pulmonary artery in an infant Fallot’s tetralogy. Catheter Cardiovasc Intervent 59:392–395CrossRefGoogle Scholar
  8. 8.
    Santoro G, Gaio G, Palladino MT, et al. (2007) Stenting of the arterial duct in newborns with duct-dependent pulmonary circulation. Heart (published online first: July 30, 2007). Doi:  10.1136/hrt.2007.123000
  9. 9.
    Santoro G, Cappelli Bigazzi M, Palladino MT, Russo MG, Carrozza M, Calabrò R (2005) Transcatheter palliation of tetralogy of Fallot with pulmonary artery discontinuity. Tex Heart Inst J 32(1):102–104PubMedGoogle Scholar
  10. 10.
    Stamm C, Friehs I, Zurakowski D, et al. (2002) Outcome after reconstruction of discontinuous pulmonary arteries. J Thorac Cardiovasc Surg 123:246–257PubMedCrossRefGoogle Scholar
  11. 11.
    Texter K, Shah A, Carlson K, Dickerson H, McKenzie ED, Justino H (2007) Persistence of bilateral arterial ducts in pulmonary atresia despite confluent branch pulmonary arteries: opportunity for two percutaneous therapeutic alternatives. Cathet Cardiovasc Intervent 70:290–295CrossRefGoogle Scholar
  12. 12.
    Trivedi KR, Karamlou T, Yoo SJ, Williams WG, Freedom RM, McCrindle BW (2006) Outcomes in 45 children with ductal origin of the distal pulmonary artery. Ann Thorac Surg 81:950–957PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Giuseppe Santoro
    • 1
    Email author
  • Giuseppe Caianiello
    • 2
  • Maria Giovanna Russo
    • 1
  • Raffaele Calabrò
    • 1
  1. 1.Division of CardiologyA.O. “Monaldi”, 2nd University of NaplesNaplesItaly
  2. 2.Division of Paediatric Cardiac SurgeryA.O. “Monaldi”, 2nd University of NaplesNaplesItaly

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