Stenting of the ductus arteriosus and banding of the pulmonary arteries: basis for various surgical strategies in newborns with multiple left XXXX .

@entity1 @entity384 @entity1699 @entity299
OBJECTIVE: To present an institutional experience with stent placement in the arterial duct combined with bilateral banding of the pulmonary artery branches as a basis for various surgical strategies in newborns with hypoplastic left @entity299 . DESIGN: Observational study. SETTING: Paediatric heart centre in a university hospital. @entity1 : 20 newborns with various forms of left @entity299 and duct dependent systemic blood flow. INTERVENTIONS: @entity1 underwent percutaneous ductal stenting and surgical bilateral pulmonary artery banding. @entity384 was performed as required, in one premature baby by the transhepatic approach. MAIN OUTCOME MEASURES: Survival; numbers of and reasons for palliative and corrective cardiac surgery. RESULTS: One @entity1 died immediately after percutaneous ductal stenting. One @entity1 died in connection with the surgical approach of bilateral pulmonary banding. Stent and ductal patency were achieved for up to 331 days. Two @entity1 underwent heart transplantation and two @entity1 died on the waiting list. Ten @entity1 had a palliative one stage procedure with reconstruction of the aortic arch and bidirectional cavopulmonary connection at the age of 3.5-6 months. There was one death. One @entity1 is still awaiting this approach. Two @entity1 received biventricular repair. In one, biventricular repair will soon be provided. CONCLUSIONS: Stenting the arterial duct combined with bilateral pulmonary artery banding in newborns with @entity1699 or multiple left @entity299 allows a broad variation of surgical strategies depending on morphological findings, postnatal clinical conditions, and potential ventricular growth.
