Abstract
Objective
To examine the technical challenges and complications of palliative ductal stenting in patients with duct-dependent pulmonary circulation in a resource limited setting.
Methodology:
This retrospective study was conducted in Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi, Pakistan covering a period from September 2020 to September 2023. The study was approved by the institutional ethical review board. Data of all patients who underwent ductal stenting for duct-dependent pulmonary circulation during the study period were explored. Demographic data of patients, details of the procedure, the immediate procedural outcome, occurrence of any immediate, and early onset complications, re-intervention procedures, and in-hospital mortality were noted. Statistical package for social sciences version 21 was used for data entry and analysis.
Results
A total of 52 patients underwent ductal stenting procedure during the study period. Males were 27 (51.9%) and females were 25 (48.1%). Age ranged from 1 day to 1460 days (Mean: 133.2 ± 257.47 days; Median: 60 days). The procedure was successful in 47 (90.4%) cases while it was unsuccessful in 5 (9.6%) cases. Seven (13.5%) patients had to undergo a re-intervention procedure raising the total number of ductal stenting procedures during the study period to 59. All of the re-intervention procedures were done successfully. Complications included stent dislodgement in 1 (1.7%) case, stent fracture in 1 (1.7%) case, stent migration in 2 (3.4%), branch pulmonary artery jailing in 5 (8.5%), and stenosis of the uncovered duct in 5 (8.5%) cases. Overall in-hospital mortality of ductal stenting was 5.1%.
Conclusion
Ductal stenting makes a reasonable palliative therapy in selected cases of duct-dependent pulmonary circulation.