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Duct dependant circulation in a neonate presents as a life threatening emergency. These patients can survive only if duct patency is maintained for the time before they are taken up for a planned staged surgery. Surgical palliative shunt, a surgical option or ductal stenting, a catheter based intervention can be performed in such patients.
We performed ductal stenting in 8 babies with duct dependant circulation with an objective to observe our results.
Patient and Methods
8 babies with age ranging from 22 hours to 18 days underwent ductal stenting (table 1). Procedure was performed under deep sedation. Venous and arterial access was obtained by Scheldinger's technique. Bare metal stents were used in all patients. Mean procedure time was 48 minutes while fluoroscopy time was 14 minutes.
The procedure was successful in all patients. 5 patients with pulmonary atresia underwent Glenn shunt at age of 6 - 7 months and are growing well while 3 patients with HLHS survived only for next 3 - 4 weeks only as next surgery (bilateral PA banding) could not be done in them.
Ductal stenting is a feasible option for initial management of patients with ductal dependant circulation till the patient is taken up for definitive surgery.
- 2013 American College of Cardiology Foundation