Use of self expanding stents in stenotic aortopulmonary shunts in adults with complex cyanotic heart disease

Objective-To describe the use of self expanding stents in treating long segment stenosis of aortopulmonary shunts (APS) in adults. Design-Clinical records, catheterisation data, cineangiograms, and operation notes of four consecutive patients undergoing stent implantation since December 1994 were studied retrospectively. Setting-A tertiary referral centre for cardiac disease. Subjects-Four patients underwent cardiac catheterisation because of clinical deterioration. Their age ranged between 23 and 32 years. The underlying diagnosis was complex cyanotic heart disease in all. Three had a stenotic interposition graft, and one had a classic Blalock shunt. Results-There was one technical failure owing to migration of the stent distal to an ostial stenosis. The ability index, resting oxygen saturation, and exercise tolerance improved in the remainder. Their medium term results have been excellent. Conclusions-This technique may further palliate adult patients with complex congenital heart disease, though the long term patency of stents is unknown.