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Right ventricular outflow tract stent versus BT shunt palliation in Tetralogy of Fallot.

Authors :
Quandt, Daniel
Ramchandani, Bharat
Penford, Gemma
Stickley, John
Bhole, Vinay
Mehta, Chetan
Jones, Timothy
Barron, David James
Stumper, Oliver
Source :
Heart; Dec2017, Vol. 103 Issue 24, p1985-1991, 7p
Publication Year :
2017

Abstract

<bold>Objective: </bold>This study sets out to compare morbidity, mortality and reintervention rates after stenting of the right ventricular outflow tract (RVOT) versus modified Blalock-Taussig shunt (mBTS) for palliation in patients with tetralogy of Fallot (ToF)-type lesions.<bold>Methods: </bold>Retrospective case review study evaluating 101 patients (64 males) with ToF lesions who underwent palliation with either mBTS (n=41) or RVOT stent (n=60) to augment pulmonary blood flow over a 10-year period. Procedure-related morbidity, mortality and reintervention rates were assessed and compared.<bold>Results: </bold>Admission rate to paediatric intensive care unit (PICU) was lower in the RVOT stent group (22% vs 100%; p<0.001). Thirty-day mortality in the RVOT stent group was (1/60 (1.7%)) compared with (2/41 (4.9%)) in the mBTS group (p=0.565). Mortality until surgical repair was comparable in both groups (5/60, 8.4%, including three non-cardiac death in the RVOT stent group vs 2/41, 4.9% (p=0.698)). Total hospital length of stay was shorter for the RVOT stent group (median 7 days vs 14 days; p<0.003). Time to surgical repair was shorter in the RVOT stent group (median 232 days, IQR 113-360) compared with the mBTS group (median 428 days, IQR 370-529; p<0.001) due to improved pulmonary arterial growth.<bold>Conclusion: </bold>RVOT stenting in Fallot-type lesions can be accomplished safely, with lower PICU admission rate, a shorter hospital length of stay and shorter duration of palliation until complete repair compared with mBTS palliation. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
13556037
Volume :
103
Issue :
24
Database :
Complementary Index
Journal :
Heart
Publication Type :
Academic Journal
Accession number :
126522959
Full Text :
https://doi.org/10.1136/heartjnl-2016-310620