Carotid artery cut-down technique for ductus arteriosus stenting

Serdar Basgoze; Ender Odemis; Akif Onalan; Bahar Temur; Selim Aydın; Fusun Guzelmeric; Ayhan Cevik; Ersin Erek

doi:10.5606/tgkdc.dergisi.2023.24598

Carotid artery cut-down technique for ductus arteriosus stenting

Turk Gogus Kalp Damar Cerrahisi Derg. 2023 Jul 27;31(3):317-324. doi: 10.5606/tgkdc.dergisi.2023.24598. eCollection 2023 Jul.

Authors

Serdar Basgoze¹, Ender Odemis², Akif Onalan¹, Bahar Temur¹, Selim Aydın¹, Fusun Guzelmeric³, Ayhan Cevik⁴, Ersin Erek¹

Affiliations

¹ Department of Pediatric Cardiovascular Surgery, Acıbadem Mehmet Ali Aydınlar University Atakent Hospital, Istanbul, Türkiye.
² Department of Pediatric Cardiology, Koç University Faculty of Medicine, Istanbul, Türkiye.
³ Department of Anesthesiology and Reanimation, Acıbadem Mehmet Ali Aydınlar University Atakent Hospital, Istanbul, Türkiye.
⁴ Department of Cardiovascular Surgery, Acıbadem Mehmet Ali Aydınlar University Atakent Hospital, Istanbul, Türkiye.

Abstract

Background: This study aims to evaluate early and mid-term outcomes of ductal stenting via carotid artery surgical cut-down technique in neonates.

Methods: Between January 2015 and January 2022, a total of 17 neonates (12 males, 5 females; median age: 14 days, range, 5 to 34 days) who underwent carotid artery surgical cut-down technique for ductal stenting were retrospectively analyzed. Diagnoses of the patients, demographics, procedural success/failure, access-related complications, and neuroimaging findings were recorded.

Results: The primary indication for ductal stenting was pulmonary atresia in all patients. All patients who underwent carotid cut-down had vertical anatomy, with or without tortuous ductal anatomy, and they were not suitable for the femoral approach. The median body weight was 3 (range, 2 to 3.4) kg. Fifteen of the 17 interventions (88.2%) were successful. Two patients whose stenting failed underwent a systemic-to-pulmonary shunt operation. The early in-hospital mortality rate was 17.6% (n=3). No neurological or accessrelated complications were observed in any of the patients.

Conclusion: Stenting the ductus arteriosus with challenging anatomy is feasible and safe with carotid artery cut-down, particularly in small neonates. Based on our study findings, this technique may offer an effective and less invasive alternative to the systemic-to-pulmonary shunt operation.

Keywords: Common carotid artery; congenital heart disease; patent ductus arteriosus; pulmonary atresia..