Prograde transcatheter aortic arch intervention in patients with single-ventricle physiology: a word of caution

Osamah Aldoss; Sonali Patel; Abhay Divekar

doi:10.1111/chd.12181

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Prograde transcatheter aortic arch intervention in patients with single-ventricle physiology: a word of caution

Journal article

Peer reviewed

Prograde transcatheter aortic arch intervention in patients with single-ventricle physiology: a word of caution

Osamah Aldoss, Sonali Patel and Abhay Divekar

Congenital heart disease, Vol.10(1), pp.64-68

01/2015

DOI: 10.1111/chd.12181

PMID: 24698084

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Abstract

We sought to review and analyze the hemodynamic derangements during prograde transcatheter aortic intervention (PTAI) in single ventricle patients. Although PTAI for postsurgical recurrent coarctation in single ventricle patients has been described; hemodynamic instability during the intervention is variably reported. Pre-, intra-, and postprocedural records and outcomes of patients with SVP undergoing PTAI for post-Norwood aortic coarctation were retrospectively reviewed. The full disclosure waveform review was used to further categorize hemodynamic derangements during the intervention. A total of 26 PTAIs were performed in 11 patients between October 2007 and December 2013. The median age and weight was 4.2 (2.3-43) months and 5.3 (3.2-15.7) kg. PTAI included balloon angioplasty (BA) in 73% of procedures (n = 19) and stent implantation (SI) in 27% (n = 7). Hemodynamic derangement was more severe in the SI group compared with the BA group. Two of seven (29%) of the SI group required cardiopulmonary resuscitation. Hemodynamic instability during PTAI is common in patients with SVP and more profound during SI. These findings have important implications for informed consent, anesthetic considerations, inotropic support, additional central venous access, and extracorporeal support/surgical backup.

Aortic Coarctation - therapy

Recurrence

Hypoplastic Left Heart Syndrome - diagnosis

Norwood Procedures - adverse effects

Risk Assessment

Humans

Risk Factors

Hypoplastic Left Heart Syndrome - surgery

Child, Preschool

Infant

Male

Treatment Outcome

Aortic Coarctation - diagnosis

Hypoplastic Left Heart Syndrome - physiopathology

Angioplasty, Balloon - adverse effects

Aorta, Thoracic - physiopathology

Angioplasty, Balloon - instrumentation

Aortic Coarctation - physiopathology

Aortic Coarctation - surgery

Aorta, Thoracic - surgery

Female

Retrospective Studies

Hemodynamics

Stents

Details

Title: Subtitle: Prograde transcatheter aortic arch intervention in patients with single-ventricle physiology: a word of caution
Creators: Osamah Aldoss - Division of Pediatric Cardiology, Department of Pediatrics, University of Iowa Children's Hospital, Iowa City, Iowa, USA
Sonali Patel
Abhay Divekar
Resource Type: Journal article
Publication Details: Congenital heart disease, Vol.10(1), pp.64-68
DOI: 10.1111/chd.12181
PMID: 24698084
ISSN: 1747-079X
eISSN: 1747-0803
Language: English
Date published: 01/2015
Academic Unit: Stead Family Department of Pediatrics
Record Identifier: 9984093209502771

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2 Times Cited - Web of Science