Objectives: To evaluate the procedural success and outcome of inter-atrial stenting. Background: Inter-atrial stenting has been shown to be an effective way to maintain inter-atrial blood flow, however it is considered a high risk procedure, usually performed urgently in patients with significant hemodynamic compromise. Methods: Between September 2004 and August 2016, inter-atrial stenting was attempted in 29 children. Procedural, clinical, and follow-up data were collected retrospectively. Results: The procedures were completed successfully in 27 patients. Twenty-five procedures were undertaken percutaneously, with the remaining four being performed as hybrid procedures. The patients were considered as high risk for adverse events (82% scored as CRISP 4 and 5) with four deaths during the first 24 hr (14%). Procedural complications occurred in eight patients (28%) with related death in three patients (10%). One further patient died after an uncomplicated technically successful stent implantation performed as a salvage procedure. Procedural complications (71% vs. 14%) and mortality (43% vs. 5%) were higher in those, who weighed 3 kg or less (P < 0.05). Patency of the stents was maintained until planned staged surgery in 22 patients at a mean of 302 days. Three patients underwent further balloon dilation for flow restriction at 58–201 days. In two un-operated patients the stents remained patent at follow-up. One patient with severe pulmonary hypertension died with a patent stent. Conclusions: Inter-atrial stenting produces reliable patency with a very good success rate. Morbidity and mortality were related to low weight at the time of the procedure.

Additional Metadata
Keywords CONP (congenital heart disease, pediatrics), SHDI (structural heart disease intervention), STEC (stenting technique)
Persistent URL dx.doi.org/10.1002/ccd.27462, hdl.handle.net/1765/114554
Journal Catheterization and Cardiovascular Interventions
Citation
Mainzer, G. (Gur), Goreczny, S. (Sebastian), Morgan, G, Qureshi, S, Krasemann, T, Dryzek, P. (Pawel), … Rosenthal, E. (2018). Stenting of the inter-atrial septum in infants and small children: Indications, techniques and outcomes. Catheterization and Cardiovascular Interventions, 91(7), 1294–1300. doi:10.1002/ccd.27462