Stenting of the inter‐atrial septum in infants and small children: Indications, techniques and outcomes

• Published in: Catheterization and cardiovascular interventions 2018-06, Vol.91 (7), p.1294-1300
• Main Authors: Mainzer, Gur, Goreczny, Sebastian, Morgan, Gareth J., Qureshi, Shakeel, Krasemann, Thomas, Dryzek, Pawel, Moll, Jadwiga A, Moszura, Tomasz, Rosenthal, Eric
• Format: Article
• Language: English
• Subjects: Balloon treatment; Blood flow; Children; Complications; CONP (congenital heart disease; Implantation; Implants; Infants; Morbidity; Mortality; Patients; pediatrics; Salvage; Septum; SHDI (structural heart disease intervention); STEC (stenting technique); Stents; Surgery
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.27462

Objectives To evaluate the procedural success and outcome of inter‐atrial stenting. Background Inter‐atrial stenting has been shown to be an effective way to maintain inter‐atrial blood flow, however it is considered a high risk procedure, usually performed urgently in patients with significant hemodynamic compromise. Methods Between September 2004 and August 2016, inter‐atrial stenting was attempted in 29 children. Procedural, clinical, and follow‐up data were collected retrospectively. Results The procedures were completed successfully in 27 patients. Twenty‐five procedures were undertaken percutaneously, with the remaining four being performed as hybrid procedures. The patients were considered as high risk for adverse events (82% scored as CRISP 4 and 5) with four deaths during the first 24 hr (14%). Procedural complications occurred in eight patients (28%) with related death in three patients (10%). One further patient died after an uncomplicated technically successful stent implantation performed as a salvage procedure. Procedural complications (71% vs. 14%) and mortality (43% vs. 5%) were higher in those, who weighed 3 kg or less (P