Abstract:

Stenting of the patent ductus arteriosus (PDA) is a relatively new method of palliative treatment ir children with congenital heart disease (CHD) and is an alternative to systemic-pulmonary shunt.

Aim: was to evaluate the efficacy of stenting in the PDA as a palliative care in children with pulmonary ductus-dependent hemodynamic in «Children Repubfcan Clinical Hospital» (CRCH).

Materials and methods: we analyzed data of 11 patients, with CHD and pulmonary ductus-dependent hemodynamics, who underwent stenting of PDA in CRCH for the period of 2007-2015. To assess the effectiveness of the procedure we took into consideration following data: clinical diagnosis; patient's condition before and after stenting of PDA.

Results: primary stenting of PDA was success in 10 patients, there was no severe complication and death. In 1 patient, there was a stent migration to the pulmonary artery, and due to the closure of the PDA and thus increasing cardiovascular insufficiency, child was taken to the corrective surgery, during which the stent was removed. As a result, in 10 successfully stented patients, in nearest follow-up observation period (15 to 28 days, mean 22 days), 7(70%) patients had a positive effect; in 3 patients progressing hypotension appeared on the 2nd day after the treatment, that leaded to pefrorming of endovascular procedures with Rashkind's method. In the later follow-up observation period, 6 of 7 patients had remaining satisfactory parameters of pulmonary hemodynamics (saturation ranged from 78% to 92%), before using of radical correction of pathology (in terms of 3 to 6 months.).

Conclusion: the stenting procedure for closing of PDA as a palliative treatment for infants with CHD and pulmonary ductus-dependent hemodynamics is effective to stabilize the severe clinical condition of patients prior to radical correction of defects in 60% of cases.  

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