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Войти в исследования Journal of cardiothoracic and vascular anesthesia · 2026
Perioperative Management for Placement of Patent Ductus Arteriosus Stents in Infants With Ductal-Dependent Pulmonary Circulation.
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Hamilton A Rebecca L, Yuki Koichi, Staffa Steven J, Odegard Kirsten C
Аннотация
OBJECTIVES: Stenting of the patent ductus arteriosus (PDA) offers a minimally invasive alternative to the modified Blalock-Thomas-Taussig shunt in infants with ductal-dependent pulmonary blood flow. This study reviews the periprocedural management of infants undergoing ductal stenting in the cardiac catheterization laboratory.
DESIGN: A retrospective single-center review.
SETTING: Quaternary children's hospital.
PARTICIPANTS: Infants receiving PDA stents in the cardiac catheterization laboratory from 2018 to 2021 were included.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Sixty-eight patients were included; median age was 5 days [1-62]; 95.6% (65/68) were neonates and 23.5% (16/68) premature. Pulmonary atresia with intact ventricular septum was the most common cardiac diagnosis (n = 23, 33.8%); 22.1% (15/68) presented with a syndrome and 35.3% (24/68) with noncardiac comorbidities. In total, 39.7% (27/68) developed intraoperative events. Median time to extubation was 19.4 hours [3.2-372.5].
CONCLUSIONS: Infants with ductal-dependent pulmonary blood flow undergoing ductal stenting may present with a wide range of challenges in the perioperative period. Meticulous care and interdisciplinary coordination are required to optimize the outcomes for this particularly vulnerable patient group.
DESIGN: A retrospective single-center review.
SETTING: Quaternary children's hospital.
PARTICIPANTS: Infants receiving PDA stents in the cardiac catheterization laboratory from 2018 to 2021 were included.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Sixty-eight patients were included; median age was 5 days [1-62]; 95.6% (65/68) were neonates and 23.5% (16/68) premature. Pulmonary atresia with intact ventricular septum was the most common cardiac diagnosis (n = 23, 33.8%); 22.1% (15/68) presented with a syndrome and 35.3% (24/68) with noncardiac comorbidities. In total, 39.7% (27/68) developed intraoperative events. Median time to extubation was 19.4 hours [3.2-372.5].
CONCLUSIONS: Infants with ductal-dependent pulmonary blood flow undergoing ductal stenting may present with a wide range of challenges in the perioperative period. Meticulous care and interdisciplinary coordination are required to optimize the outcomes for this particularly vulnerable patient group.