Stenting in Congenital Heart Disease

– Medium- and Long-Term Outcomes From the JPIC Stent Survey –

Abstract

Background: Medium- and long-term efficacy of intravascular stenting for congenital heart disease (CHD) has not been determined in Japan. Methods and Results: The study comprised a retrospective survey of Palmaz or Palmaz Genesis stent implantation for pulmonary artery stenosis (PA), aortic coarctation, and superior and inferior vena cava lesions (SIVC) from May 1995 to February 2009, occurring in association with pre- or postoperative CHD at 14 leading hospitals. Stents were implanted in 255 patients with 312 lesions (PA, 253 lesions in 199 patients; aorta, 38 lesions in 35 patients; SIVC, 21 lesions in 21 patients). Age at the initial stenting was median 10 years, and the follow-up interval ranged from 6 to 144 months. The minimum lumen diameter (MLD) of the PA, aorta, and SIVC was increased from 4.7±2.1, 6.6±2.3, and 4.4±2.2 mm to 8.8±2.7, 12.0±3.8, and 9.2±2.6 mm, respectively (P<0.01). Cumulative freedom from redilation was 84% at 72 months, 95% at 54 months, and 81% at 50 months, for the PA, aorta, and SIVC, respectively. In 187 redilations, the MLD of the PA, aorta, and SIVC increased from 6.1±2.5, 7.9±2.9, and 5.3±2.4 mm, to 8.3±2.7, 9.8±3.5, and 7.3±1.9 mm, respectively (P<0.01). There were no deaths associated with stent implantation. Conclusions: Percutaneous stenting using Palmaz or Palmaz Genesis stents and redilation are now common procedures in Japan with little morbidity during the medium- and long-term follow-up period.  (Circ J 2010; 74: 1676 - 1683)