Abstract Ref Number = APCP215
DUCTAL SHUNTED VERSUS STENTING DUCT-DEPENDENT PULMONARY CIRCULATION
Ni Putu Veny Kartika Yantie,Eka Gunawijaya,Panthip Pattarakunwiwat,Thanarat Layangool ,Worakan Promphan
Department of Child Health Medical Faculty of Udayana University Bali Indonesia Department of Child Health, Medical Faculty of Udayana University, Bali, Indonesia Pediatric Heart Center, Queen Sirikit National Institute of Child Health, Rangsit University, Bangkok, Thailand
Background : Neonatal surgical palliative systemic to pulmonary artery shunt is still a major cause of mortality and morbidity. Recently, ductal stenting (DS) is an effective alternative modality to provide adequate blood flow in neonatal congenital heart disease with duct-dependent pulmonary circulation. the aim of this study was to assess feasibility and outcomes of DS in comparison to a conventional modified Blalock-Taussig shunt (MBTS) with duct-dependent pulmonary circulation.
Material : A single-institution retrospective cohort study was conducted in neonates who underwent MBTS and DS. Analysis of survival, procedural complications, rate of re-stenosis and re-intervention were done. Log rank (Mantel-cox) was done to compare the means and median re-stenosis survival time
Results : A total of 67 subject ?12-month-old were identified. Eighteen subjects underwent DS and 49 subjects underwent MBTS. The length of stay and overall hospital mortality were similar. Pneumonia intra-hospital and sepsis after procedure were higher in MBTS group. The mean and median survival time for re-stenosis of DS and MTBS was 25.32 and 77.82 months (p=0.001) respectively, however the rate of re-intervention was not different.
Conclusions : DS and MBTS in aged ?12 months are feasible and may provide an effective systemic to pulmonary artery shunt in duct-dependent pulmonary circulation in our institution, however DS efficacy gradually reduce
Keywords: ductal stenting ductal shunted re-stenosis intervention