Ductus Arteriosus Stenting in Congenital Heart Disease
Summary
Ductus arteriosus stenting has emerged as a pivotal minimally invasive approach to secure pulmonary blood flow in neonates and infants with cyanotic congenital heart disease that are duct dependent. By implanting a bare-metal or drug-eluting scaffold within the patent ductus arteriosus (PDA), interventional cardiologists can avoid the morbidity associated with thoracotomy and cardiopulmonary bypass required for surgical shunts. Advances in delivery systems, imaging guidance and antithrombotic protocols have expanded case selection to include long, tortuous or vertically oriented ducts previously deemed unsuitable. Current practice balances the need for reliable palliation against risks of acute stent thrombosis, vessel injury and in-stent stenosis, with strategies for staged redilation or reintervention forming part of comprehensive care pathways. In many centres, ductal stenting now stands alongside the modified Blalock–Taussig shunt as a first-line palliative option, offering shorter intensive care and hospital stays, improved pulmonary artery growth and a bridge to definitive repair or staged cavopulmonary connection.
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Ductus Arteriosus Stenting in Congenital Heart Disease publication trend
The graph below shows the total number of articles in ductus arteriosus stenting in congenital heart disease across all publications each year (not limited to Nature Index journals).
Technical terms
Patent Ductus Arteriosus (PDA): A normal fetal vessel linking the pulmonary artery to the descending aorta, which usually closes soon after birth.
Duct-dependent pulmonary circulation: A physiology in which pulmonary blood flow is maintained exclusively by the PDA in the setting of severe right-sided obstruction or atresia.
Blalock–Taussig shunt: A surgical graft connecting the subclavian artery to the pulmonary artery to augment pulmonary blood flow.
Stent thrombosis: Acute or subacute occlusion of a stented vessel due to platelet aggregation and clot formation.
Ductal tortuosity: The degree of curvature and complexity in the PDA’s course, influencing ease of stent delivery and expansion.
References
- Transcatheter Interventions for Neonates with Congenital Heart Disease: A Review. Diagnostics (2023).
- Stenting the ductus arteriosus: Case selection, technique and possible complications. Annals of Pediatric Cardiology (2008).
- Outcome of ductus arteriosus stenting including vertical tubular and convoluted tortuous ducts with emphasis on technical considerations. The Egyptian Heart Journal (2021).
- Margin between success and failure of PDA stenting for duct-dependent pulmonary circulation. PLOS ONE (2022).
- Systematic approach to obtain axillary arterial access for pediatric heart catheterizations. Frontiers in Cardiovascular Medicine (2024).
- PDA Stenting for Ductal-Dependent Cyanotic Congenital Heart Disease: History and View From 10,000 Feet. Pediatric Cardiology (2024).
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