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Cardiology Insights 2019
Journal of Heart and Cardiovascular Research
ISSN: 2576-1455
Page 41
March 07-08, 2019
Berlin, Germany
New Horizons in Cardiology
& Cardiologists Education
22
nd
International Conference on
J Heart Cardiovasc Res 2019, Volume 3
DOI: 10.21767/2576-1455-C1-003
Stenting ductus arteriosus via axillary artery vs. femoral vein
in infants
Murtaza Kamal, Nitin K Rao
and
Suman Vyas
Star Hospitals, Hyderabad, India
Introduction
: Stenting of the ductus arteriosus is
necessary to maintain duct dependent circulation.
The ductal morphology predicts not only the technical
difficulty in stenting but also the risks of restenosis
necessitating reintervention.
Aim&Objectives
: To retrospectively review the outcomes
of ductal stenting in children via different routes, present
a technique of ductal stenting via axillary artery and
compare it with femoral access.
Materials & Methods
: Twenty three patients with
duct dependent circulation were treated with stent
implantation. These patients were included in the study
retrospectively. In 19 (82%) of these patients, duct
stenting was done through the femoral venous route. In
4 (18%) of the cases the axillary artery was favored to
transvenous approach for ductal stenting.
Results
: PDA stenting was done for four cases in which
axillary approach was used. All of the 4 cases received
prostaglandin infusion.Themedianage at procedure time
was 12 days (range: 4- 18 days) with a median weight of
2.9 kg (range: 2.7-3.3 kg). All the babies were term. One
had pulmonary atresia intact septum, 1- complete AV
canal defect with PA and unbalanced ventricles and 2
had TOF with PA. The median ductal diameter was 2.4
mm (range: 2.2-3.4 mm) with median ductal length of
15 mm (range: 10-22 mm). The median procedure time
was 78 minutes (range: 70-118 minutes) with median
fluoroscopic time of 32 minutes (range: 26-42 minutes).
Fluoroscopic time was significantly shorter in those with
axillary approach.
Conclusion
: The axillary arterial access is an effective
approach to stent the arterial duct in newborns with
duct-dependent circulation. Compared with anterograde
approach via the femoral vein, positioning the wire into
the vertical duct via the axillary artery is much more
feasible.This increases success rates aswell as shortens
the duration of procedure and reduces complications.