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Coronary Interventions in Pediatric Congenital Heart Disease
Coronary artery lesions represent rare conditions in pediatric congenital heart disease and mainly include coronary artery stenoses (CAS) or coronary artery fistulae (CAF). Due to the small vessel size, pediatric percutaneous coronary interventions (PCI) are demanding and studies concerning long-ter...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9005385/ https://www.ncbi.nlm.nih.gov/pubmed/34902048 http://dx.doi.org/10.1007/s00246-021-02784-x |
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author | Schleiger, Anastasia Kramer, Peter Dreysse, Stephan Schubert, Stephan Peters, Björn Photiadis, Joachim Berger, Felix Nordmeyer, Johannes |
author_facet | Schleiger, Anastasia Kramer, Peter Dreysse, Stephan Schubert, Stephan Peters, Björn Photiadis, Joachim Berger, Felix Nordmeyer, Johannes |
author_sort | Schleiger, Anastasia |
collection | PubMed |
description | Coronary artery lesions represent rare conditions in pediatric congenital heart disease and mainly include coronary artery stenoses (CAS) or coronary artery fistulae (CAF). Due to the small vessel size, pediatric percutaneous coronary interventions (PCI) are demanding and studies concerning long-term results are missing. In this retrospective study, we analyzed indications, procedural details, and post-procedural outcomes in pediatric patients who underwent PCI in our institution. For CAS treatment, procedural success was defined as efficient coronary revascularization with a significant improvement of coronary perfusion. CAF treatment was considered successful, when no residual shunt was detectable. From 1995 to 2020, 32 pediatric patients aged ≤ 18 years received interventional treatment for CAS (n = 24/32) or CAF (n = 8/32). Reasons for CAS were post-surgical (n = 15/24) or post-transplant (n = 9/24). Interventional treatment strategies included coronary angioplasty (20/43), stent placement (10/43), and a combination of both (13/43). In-hospital mortality occurred in 6/24 patients and late mortality in 5/24 patients leading to an overall 5-year survival of 62.5%. Early mortality mainly occurred due to post-ischemic myocardial failure. CAF occlusion was performed using coil embolization (n = 3), placement of vascular plugs (n = 3), a combination of both (n = 1), or a combination of coil embolization and a covered stent (n = 1). Treatment of coronary fistulae was successful in all patients with excellent post-procedural results and no follow-up death. PCI in pediatric patients with congenital heart disease can be performed safely and effectively. However, the overall 5-year survival probability of patients with CAS is reduced due to severe ischemic myocardial damage. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00246-021-02784-x. |
format | Online Article Text |
id | pubmed-9005385 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-90053852022-04-14 Coronary Interventions in Pediatric Congenital Heart Disease Schleiger, Anastasia Kramer, Peter Dreysse, Stephan Schubert, Stephan Peters, Björn Photiadis, Joachim Berger, Felix Nordmeyer, Johannes Pediatr Cardiol Original Article Coronary artery lesions represent rare conditions in pediatric congenital heart disease and mainly include coronary artery stenoses (CAS) or coronary artery fistulae (CAF). Due to the small vessel size, pediatric percutaneous coronary interventions (PCI) are demanding and studies concerning long-term results are missing. In this retrospective study, we analyzed indications, procedural details, and post-procedural outcomes in pediatric patients who underwent PCI in our institution. For CAS treatment, procedural success was defined as efficient coronary revascularization with a significant improvement of coronary perfusion. CAF treatment was considered successful, when no residual shunt was detectable. From 1995 to 2020, 32 pediatric patients aged ≤ 18 years received interventional treatment for CAS (n = 24/32) or CAF (n = 8/32). Reasons for CAS were post-surgical (n = 15/24) or post-transplant (n = 9/24). Interventional treatment strategies included coronary angioplasty (20/43), stent placement (10/43), and a combination of both (13/43). In-hospital mortality occurred in 6/24 patients and late mortality in 5/24 patients leading to an overall 5-year survival of 62.5%. Early mortality mainly occurred due to post-ischemic myocardial failure. CAF occlusion was performed using coil embolization (n = 3), placement of vascular plugs (n = 3), a combination of both (n = 1), or a combination of coil embolization and a covered stent (n = 1). Treatment of coronary fistulae was successful in all patients with excellent post-procedural results and no follow-up death. PCI in pediatric patients with congenital heart disease can be performed safely and effectively. However, the overall 5-year survival probability of patients with CAS is reduced due to severe ischemic myocardial damage. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00246-021-02784-x. Springer US 2021-12-13 2022 /pmc/articles/PMC9005385/ /pubmed/34902048 http://dx.doi.org/10.1007/s00246-021-02784-x Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Schleiger, Anastasia Kramer, Peter Dreysse, Stephan Schubert, Stephan Peters, Björn Photiadis, Joachim Berger, Felix Nordmeyer, Johannes Coronary Interventions in Pediatric Congenital Heart Disease |
title | Coronary Interventions in Pediatric Congenital Heart Disease |
title_full | Coronary Interventions in Pediatric Congenital Heart Disease |
title_fullStr | Coronary Interventions in Pediatric Congenital Heart Disease |
title_full_unstemmed | Coronary Interventions in Pediatric Congenital Heart Disease |
title_short | Coronary Interventions in Pediatric Congenital Heart Disease |
title_sort | coronary interventions in pediatric congenital heart disease |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9005385/ https://www.ncbi.nlm.nih.gov/pubmed/34902048 http://dx.doi.org/10.1007/s00246-021-02784-x |
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