Artikel Jurnal
Stenting of Ductus Arteriosusfor Duct-Dependent Pulmonary Circulation: An Emergency and Life Saving Procedure
Background : Critical congenital heart defect with ductal-dependent pulmonary flow
presents as a life-threatening condition. The patency of ductus arteriosus is required to
supply blood flow into the lung. Stent implantation into ductus arteriosus has been
proposed as non-surgical management for critical congenital heart disease with duct-
dependent.
Case Description: We present full-term newborns who had critical congenital heart
disease with ductal-dependent pulmonary blood blow and successfully managed with
ductal stenting. Patient A, a 13-days-old male newborn had Tetralogy of Fallot-Pulmonary
Atresia, restrictive Ventricular Septal Defect (VSD) and patent ductus arteriosus (PDA).
Patient B, a 5-days-old female newborn had Tricuspid Atresia, restrictive VSD, PDA, and
multiple congenital anomaly. Patient C, a 2-days-old female newborn had PA-IVS, PDA
with stretched Patent Foramen Ovale (PFO). Prostaglandin-E1 infusion was started at first
and stopped 6 hours prior to the procedure. All patients underwent ductus arteriosus
stenting via femoral artery approach with drug-eluting stent. Pulmonary vascular
markings were increased and oxygen saturations were improved in all of the patient.
5-month follow up, patients were in stable condition and prepared for surgical correction.
Discussion : Ductal stenting in patient with duct-dependent pulmonary circulation
appears to be an alternative to surgery. It provides bridging palliation until the time of
definitive surgery. The effectiveness of the procedure was highlighted by the fact that all
the patients showed a significant improvement in arterial saturation and pulmonary
vascular marking.
Conclusion : Stenting of ductus arteriosus is feasible and safe with great result. Early
detection and timely management are imperative to save the life.
Keywords : critical congenital heart defect, ductus arteriosus, ductal stenting, ductal-
dependent pulmonary blood flow
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