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Sultan Qaboos Univ Med J ; 23(Spec Iss): 10-15, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38161753

RESUMO

Objectives: There is limited data published from outside North America and Europe comparing the outcomes of a modified Blalock-Taussig shunt (MBTS) and ductal stenting as the first palliative procedure for infants with duct-dependent pulmonary circulation. This study reports the National Heart Center's, in Muscat, Oman, experience in comparing the outcomes of these 2 interventions. Methods: This retrospective study included all infants with duct-dependent pulmonary circulation who received either a MBTS or ductal stenting from 2016-2019. The primary outcomes were death or re-interventions. Secondary outcomes included death, subsequent re-interventions, survival to subsequent surgical intervention, survival to hospital discharge, post-procedural mechanical ventilation and duration of intensive care unit stay. Results: A total of 71 patients were included in the study, 33 (46%) of whom received ductal stenting. The prevalence of the primary outcome (death or re-intervention) in the patent ductus arteriosus (PDA) stent group was 54.5% versus 31.6% in the MBTS group but this was not statistically significant (P = 0.06). There was no difference between the 2 groups in terms of time to next surgical intervention (P = 0.233). The PDA stent group had shorter post-procedural, mechanical ventilation and intensive care unit stay durations (P <0.05). Syndromic patients were at higher risk of mortality compared to non-syndromic patients. Conclusion: MBTS and ductal stenting are both acceptable modalities as a palliative intervention for infants with duct-dependant pulmonary circulation. Syndromic patients are at higher risk of mortality. This can be considered an important factor for patient selection.


Assuntos
Procedimento de Blalock-Taussig , Permeabilidade do Canal Arterial , Lactente , Humanos , Procedimento de Blalock-Taussig/efeitos adversos , Procedimento de Blalock-Taussig/métodos , Circulação Pulmonar , Estudos Retrospectivos , Cateterismo Cardíaco/efeitos adversos , Cuidados Paliativos/métodos , Resultado do Tratamento , Permeabilidade do Canal Arterial/cirurgia , Permeabilidade do Canal Arterial/etiologia , Stents
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