Hybrid intraoperative pulmonary artery stent placement for XXXX .

@entity1 @entity1145 @entity215 @entity338 @entity849 @entity358 @entity887 @entity299 @entity1146 @entity850
@entity358 (PA) stenting can be challenging, especially in @entity1 with @entity850 of the right ventricular (RV) outflow tract or tortuous PA branches. In these cases, a hybrid procedure deploying PA stent(s) during cardiac surgery provides an alternative to relieve @entity849 . The Mayo Clinic Congenital Cardiac surgical database was used to identify all @entity1 having hybrid PA stent procedures. Retrospective analysis of clinical data, procedural details, and outcomes was performed. Between January 1997 and November 2006, 24 @entity1 (15 females), median age 15 years (range 3 to 67 years), had hybrid PA stent procedures. A total of 27 stents were deployed. A left PA stent was placed in 13, right PA stent in 8; 3 @entity1 had bilateral PA stents. Primary cardiac diagnoses were @entity1146 (9), @entity215 (7), @entity1145 (2), and others (6). Maximum balloon diameters ranged from 8 to 16 mm (median = 12 mm). Concomitant surgical procedures performed were RV to PA conduit replacement or RV outflow tract reconstruction (14), @entity338 (7), and others (3). Two procedures were performed following complications of percutaneous procedure. There were no deaths or PA damage. There were 2 cases of distal stent migration. Repeat stent dilations within 6 months were performed in 3 @entity1 . In conclusion, hybrid PA stenting can play an important role in the management of @entity299 with complex branch PA anatomy. It also can be used as an emergency rescue procedure following complications of percutaneous transcatheter procedures, such as @entity887 . Hybrid procedures were safe and effective in most @entity1 , although stent positioning remains critical. Intraoperative fluoroscopy and active suture fixation of the proximal stent may reduce the need for late reintervention.
