Coronary Interventions in Pediatric Congenital Heart Disease

被引:0
作者
Anastasia Schleiger
Peter Kramer
Stephan Dreysse
Stephan Schubert
Björn Peters
Joachim Photiadis
Felix Berger
Johannes Nordmeyer
机构
[1] German Heart Centre Berlin,Department of Congenital Heart Disease/Pediatric Cardiology
[2] German Heart Centre Berlin,Department of Cardiology
[3] Herz- und Diabeteszentrum NRW - Clinic for Pediatric Cardiology and Congenital Heart Defects,Department of Congenital Heart Surgery/Pediatric Heart Surgery
[4] German Heart Centre Berlin,Division of Cardiology, Department of Pediatrics
[5] DZHK (German Center for Cardiovascular Research),undefined
[6] Partner Site Berlin,undefined
[7] Charité-Universitätsmedizin Berlin,undefined
来源
Pediatric Cardiology | 2022年 / 43卷
关键词
Percutaneous coronary intervention; Coronary artery stenosis; Coronary fistula; Cardiac allograft vasculopathy; Pediatric congenital heart disease;
D O I
暂无
中图分类号
学科分类号
摘要
Coronary artery lesions represent rare conditions in pediatric congenital heart disease and mainly include coronary artery stenoses (CAS) or coronary artery fistulae (CAF). Due to the small vessel size, pediatric percutaneous coronary interventions (PCI) are demanding and studies concerning long-term results are missing. In this retrospective study, we analyzed indications, procedural details, and post-procedural outcomes in pediatric patients who underwent PCI in our institution. For CAS treatment, procedural success was defined as efficient coronary revascularization with a significant improvement of coronary perfusion. CAF treatment was considered successful, when no residual shunt was detectable. From 1995 to 2020, 32 pediatric patients aged ≤ 18 years received interventional treatment for CAS (n = 24/32) or CAF (n = 8/32). Reasons for CAS were post-surgical (n = 15/24) or post-transplant (n = 9/24). Interventional treatment strategies included coronary angioplasty (20/43), stent placement (10/43), and a combination of both (13/43). In-hospital mortality occurred in 6/24 patients and late mortality in 5/24 patients leading to an overall 5-year survival of 62.5%. Early mortality mainly occurred due to post-ischemic myocardial failure. CAF occlusion was performed using coil embolization (n = 3), placement of vascular plugs (n = 3), a combination of both (n = 1), or a combination of coil embolization and a covered stent (n = 1). Treatment of coronary fistulae was successful in all patients with excellent post-procedural results and no follow-up death. PCI in pediatric patients with congenital heart disease can be performed safely and effectively. However, the overall 5-year survival probability of patients with CAS is reduced due to severe ischemic myocardial damage.
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页码:769 / 775
页数:6
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