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IMPLANTE DE STENTS EN RAMAS DE ARTERIAS PULMONARES EN CARDIOPATIAS CONGENITAS: EXPERIENCIA MULTICENTRICA EN 10 AÑOS;
Pulmonary Artery Branch Stent Implantation in Congenital Heart Disease: A 10-Year Multicenter Experience

Creators:Peirone, Alejandro, Contreras, Alejandro, Cabrera, Marcelo, Ferrero Guadagnoli, Adolfo, Gentiletti, Anibal, Schroch, Ana, Laghezza, Lidia, Juaneda, Ignacio, Díaz, Juan, Kreutzer, Christian
2016-02-29

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Descripción

Introducción: La angioplastia con implante de stent es considerado el tratamiento de elección para la mayoría de los casos de estenosis congénita o adquirida post quirúrgica de ramas de arterias pulmonares en pacientes portadores de cardiopatías congénitas. Sin embargo, aún persisten dudas sobre la efectividad clínica e incidencia de complicaciones de esta técnica que necesitan ser esclarecidas. Material y métodos: Estudio multicéntrico descriptivo- retrospectivo-observacional. Los procedimientos fueron realizaron desde enero del 2005 hasta abril del 2015. Un total 25 pacientes fueron sometidos a angioplastia con implante de stent en ramas de arterias pulmonares los cuales fueron seguidos evolutivamente en su estado clínico y por diferentes métodos de imágenes. Se definió buena efectividad clínica al mejoramiento clínico sintomático y/o anatómico persistente del paciente intervenido.   Resultados: La totalidad de la cohorte de 25 pacientes tenían una edad promedio de  9,48 años (2 meses–34 años), un peso promedio de 27,54 kg (3-104) y 44% correspondieron a sexo femenino. Las cardiopatías congénitas de base intervenidas fueron en su mayoría tetralogía de Fallot y sus variantes, seguido por corazones con fisiología univentricular post cirugías de Glenn bidireccional y/o Fontán-Kreutzer. La presión sistólica del ventrículo derecho y de la arteria pulmonar disminuyeron significativamente post-intervención (68,3 mmHg a 45,8 mmHg  y 47,4 mmHg a 32 mmHg, respectivamente) (p&lt; 0,0001). El mínimo diámetro de la lesión a tratar  incrementó significativamente post-procedimiento (3,98 mm a 9,82 mm, p&lt; 0,0001). La incidencia de complicaciones fue del 8% (2 pacientes) y una buena efectividad clínica fue registrada en 22 pacientes (88%).Conclusión: La angioplastia con colocación de stent en las ramas de arterias pulmonares resultó en una técnica segura y eficaz aunque desafiante, con una marcada mejoría clínica y anatómica de las lesiones tratadas. Representa una alternativa a la cirugía disminuyendo el riesgo de reintervenciones en pacientes con cardiopatías congénitas.

Background: Stent implant is considered the treatment of choice for most cases of congenital or postoperative pulmonary artery branch stenosis in patients with congenital heart defects. However, there are still doubts on the clinical effectiveness and the incidence of complications of this technique that need to be elucidated.Methods: This multicenter study has a descriptive, observational and retrospective design. The procedures were performed between January 2005 and April 2015. Twenty-five patients with pulmonary artery branch stenosis underwent stent implant and were followed-up both clinically and by different imaging tests. Persistent clinical and/or anatomic improvement defined clinical effectiveness.Results: Average age was 9.48 years (2 months-34 years), mean weight was 27.54 kg (3-104 kg) and 44% were women. The most frequent congenital heart defects in the treated cohort were tetralogy of Fallot and its variants, followed by single ventricle heart physiology after bidirectional Glenn shunt and/or Fontan-Kreutzer procedures. Right ventricular systolic and pulmonary artery pressure decreased significantly after the intervention (from 68.35 mmHg to 45.8 mmHg and from 47.4 mm Hg to 32 mm Hg, respectively) (p &lt; 0.0001). The initial minimum diameter of the treated pulmonary artery branch increased significantly after the procedure (from 3.98 mm to 9.82 mm, p &lt; 0.0001). The incidence of complications was 8% (n = 2) and the clinical effectiveness of the procedure was good in 22 patients (88%).Conclusions: Stent implant in pulmonary artery branch stenosis is a safe and feasible though challenging technique, with significant clinical and anatomic improvement. The procedure represents an alternative to surgery and decreases the need for reinterventions in patients with congenital heart defects.

Metadatos destacados

Colecciones
Argentine Journal of Cardiology

Editor

Sociedad Argentina de Cardiología

Fuente

Revista Argentina de Cardiología; Vol 84, No 1 (2016); 21-26, Argentine Journal of Cardiology; Vol 84, No 1 (2016); 21-26

Citación

Peirone, Alejandro et al., “IMPLANTE DE STENTS EN RAMAS DE ARTERIAS PULMONARES EN CARDIOPATIAS CONGENITAS: EXPERIENCIA MULTICENTRICA EN 10 AÑOS,” Archivo PPCT, consulta 2 de abril de 2026, http://archivoppct.caicyt.gov.ar/items/show/8677.

Dublin Core

Autor

Peirone, Alejandro
Contreras, Alejandro
Cabrera, Marcelo
Ferrero Guadagnoli, Adolfo
Gentiletti, Anibal
Schroch, Ana
Laghezza, Lidia
Juaneda, Ignacio
Díaz, Juan
Kreutzer, Christian

Fuente

Revista Argentina de Cardiología; Vol 84, No 1 (2016); 21-26
Argentine Journal of Cardiology; Vol 84, No 1 (2016); 21-26

Editor

Sociedad Argentina de Cardiología

Fecha

2016-02-29

Derechos

Los que firman al pié, certificamos que tenemos total responsabilidad por la conducción de este estudio y por el diseño y la interpretación de los datos. Nosotros escribimos el manuscrito y somos responsables por la decisión acerca del mismo. Cada uno de nosotros cumple la definición de autor como se afirma en el Comité Internacional de Editores de Revistas Médicas (International Committee of Medical Journal Editors, ver www.icmje.org). Nosotros hemos visto y aprobado el manuscrito final. Ni el artículo, ni ninguna parte esencial del mismo, incluido las tablas y las figuras, será publicado o admitido para arbitrar a otra parte antes de aparecer en la Revista.También notificamos haber leído la sección “conflicto de intereses”, y revelaríamos cualquiera que existiera. Dejamos constancia que si nuestro artículo se publicara en la RAC, cederíamos los derechos (copyright) a la Revista.Los documentos publicados en esta revista están bajo la licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.
Those signing below certify that we have full responsibility for the conduction of this study and for the design and interpretation of the information. We wrote the manuscript and are responsible for its decision. Each of us fulfills the definition of authorship as stated by the International Committee of Medical Journal Editors ( www.icmje.org). We have signed and approved the final manuscript. Neither the manuscript, nor any essential part thereof, including tables and figures, will be published or accepted for refereeing elsewhere before being published in the Journal. We have also read the "Conflict of Interest" section and would disclose any existing. We state that if our manuscript is published in the RAC, we shall transfer the copyright to the Journal.

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info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion