Objectives: Presentation of four stents implantation in three patients with non-surgically treated pulmonary atresia, ventricular septal defect and multiple aortopulmonary collaterals (PA, VSD, MAPCAs), who underwent stent implantations into the stenosed MAPCAs.
This congenital cardiopathy has a severe prognosis. We have 21 non-surgically treated and 15 surgically treated patients with PA, VSD, MAPCAs in our institution. These patients could survive due to pulmonary blood perfusion through the aortopulmonary collateralls. As time passed, the stenoses of MAPCAs formed, resulting in progression of hypoxemia and cyanosis. The level of NYHA impaired and neurological complications were likely to be present as well. Stent implantations into the stenosed segments of MAPCAs are only possible non-surgical effective palliative intervention for these patients after precise isotropic high resolution multislice CT-angiography delineation of MAPCAs.
Methods: The comparison of blood oxygenation parameters, neurological complications and level of NYHA before and after stent implantations into the stenosed segments of MAPCAs in three adult patients with non-surgically treated PA, VSD, MAPCAs.
Results: All patients with non-surgically treated PA, VSD, MAPCAs after J&J Palmaz Genesis 6 mm premounted stent implantations showed encouraging results in improvement of blood oxygenation parameters, neurological complications and level of NYHA. High resolution multislice CT-angiography in all cases confirmed proper site of implanted stents and improvement in blood perfusion of pulmonary segments supplied by dilated collateral.
Conclusions: Stent implantations into the stenosed segments of MAPCAs seem to be only effective non-surgical paliative intervention, which can improve quality of life in non-surgically treated patients with PA, VSD, MAPCAs.