Outcomes of Ductus Arteriosus Stenting in Neo-nates with Pulmonary Valve Atresia and Ventricu-lar Septal Defect

Patent Ductus Arteriosus (PDA) stenting is an interventional method to supply pulmonary blood flow in patients with ductal dependent pulmonary blood flow. This study was conducted to evaluate neonatal PDA stenting at Shiraz University of Medical Sciences, Shiraz, Iran.

Thirty neonates with a diagnosis of pulmonary valve atresia and ventricular septal defect (VSD) were included in this study. Neonatal PDA stenting had been performed on them from February 2017 to November 2019 at Shiraz University of Medical Sciences. The mortality rate, stent lumen stenosis and stent redilation and also SpO2 of all the patients were assessed before stenting and one year after and compared with the data from other studies. A CT angiography of the aorta and pulmonary arteries had been performed on ten patients at the age of one year; the McGoon ratio was calculated for them and compared against this ratio at their neonatal angiography.

PDA stenting was successful in 23 cases (77%) and non-successful in seven cases (23%); meanwhile, four patients expired during or early after stenting. Regarding the access sites for PDA stenting, 22 PDAs were accessed via the axillary artery, six via the femoral arteries and two via the inferior vena cava using an antegrade approach. SpO2 and the McGoon ratio had improved significantly one year after stenting compared to before, with SpO2 increasing from 54.43±6.54 to 83±7.33 and McGoon ratio from 1.18±0.23 to 1.67±0.31.

Ductal stenting is an effective and less invasive therapeutic method for increasing arterial O2 saturation and maintaining pulmonary blood flow. Most of our patients had good SpO2 one year after PDA stenting without any additional re-intervention and the McGoon ratio had increased sufficiently in them.