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History Of Ductal Stent Is Associated With Pulmonary Artery Interventions After Superior Cavopulmonary Connections
Ryan R. Davies, Yousef Arar, Timothy J. Pirolli, Olivia Hoffman, Robert D. B. Jaquiss.
UTSW/Children's Health Dallas, Dallas, TX, USA.

Objective(s): Stenting of the ductus arteriosus has become increasingly common as the initial palliation for patients with ductal dependent blood flow. Often ductal stents protrude into the pulmonary artery; the long-term impact on the need for pulmonary artery reinterventions has not been assessed.
Methods: We performed a retrospective review of all patients (2010-2021, n=325) undergoing superior cavopulmonary connection (SCPC) at a single institution. Patients with a history of ductal stenting (DS, n=41, 12.6%) were compared to those without (noDS, n=284, 87.4%). The need for PA interventions (surgical arterioplasty, balloon angioplasty, stent implantation) was assessed.
Results: The use of ductal stenting has increased (2010-2015, 11/166, 3.4% vs. 2016-2021, 30/159, 9.2%; p=0.0009). DS patients were much more likely to undergo surgical pulmonary arterioplasty at the time of SCPc than NoDS patinets (OR 6.1, 95% CI 2.5-15.0). Freedom from post-SCPC pulmonary artery interventions was worse in the DS group than in the noDS group (Figure, p=0.01; Cox regression hazard ratio: 2.4, 95%CI 1.2-4.8).
Conclusions: In patients undergoing SCPC, palliation with DS is associated with a higher rate of simultaneous and late pulmonary intervention as compared to patients with other types of regulated pre-SCPC pulmonary blood flow.


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