Compression of the left mainstem bronchus by patent ductus arteriosus in neonates under consideration for ductal stenting

Catheter Cardiovasc Interv. 2020 May 1;95(6):1158-1162. doi: 10.1002/ccd.28735. Epub 2020 Jan 20.

Abstract

Stent angioplasty of patent ductus arteriosus has been shown to be a viable alternative to operative shunt placement in cyanotic neonates. With broader implementation of this strategy, novel complications are bound to arise. We present a series of cases evaluated for ductal stent angioplasty in which a dilated and torturous ductus arteriosus compressed the left mainstem bronchus. After reviewing our recent experience with ductal stenting and isolated Blalock-Taussig shunts, our best estimate of the incidence of bronchial compression by the dilated ductus is 4.6% (3/64, 95% confidence interval 1.0-12.9%). Awareness of the airway and other nonvascular contents of the thorax is an important consideration prior to ductal stenting.

Keywords: COMP-complications, pediatric catheterization/intervention; CONP-congenital heart disease, pediatrics; PEDI-pediatric intervention.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Review
  • Video-Audio Media

MeSH terms

  • Airway Obstruction / diagnostic imaging
  • Airway Obstruction / etiology*
  • Airway Obstruction / physiopathology
  • Angioplasty / adverse effects
  • Angioplasty / instrumentation
  • Blalock-Taussig Procedure
  • Bronchi* / diagnostic imaging
  • Bronchi* / physiopathology
  • Clinical Decision-Making
  • Ductus Arteriosus, Patent / complications*
  • Ductus Arteriosus, Patent / diagnostic imaging
  • Ductus Arteriosus, Patent / physiopathology
  • Ductus Arteriosus, Patent / therapy
  • Female
  • Humans
  • Infant, Newborn
  • Palliative Care
  • Risk Factors
  • Stents
  • Treatment Outcome