Stenting in congenital heart disease: medium- and long-term outcomes from the JPIC stent survey

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Pediatric Cardiology

Background:

• Efficacy of intravascular stenting for congenital heart disease (CHD) in Japan requires further evaluation.
• Limited data exists on the medium- and long-term outcomes of stenting for complex CHD.
• Palmaz and Palmaz Genesis stents are utilized for various cardiovascular lesions.

Purpose of the Study:

• To determine the medium- and long-term efficacy of intravascular stenting in Japanese patients with CHD.
• To evaluate the outcomes of Palmaz or Palmaz Genesis stent implantation for pulmonary artery stenosis, aortic coarctation, and vena cava lesions.
• To assess the safety and effectiveness of redilation procedures in conjunction with stenting.

Main Methods:

• Retrospective survey of 255 patients with 312 lesions (pulmonary artery, aorta, vena cava) treated between May 1995 and February 2009.
• Analysis of Palmaz or Palmaz Genesis stent implantation in pre- or postoperative CHD.
• Follow-up duration ranged from 6 to 144 months, with assessment of minimum lumen diameter and need for redilation.

Main Results:

• Significant increases in minimum lumen diameter for pulmonary artery, aorta, and vena cava lesions post-stenting (P<0.01).
• Cumulative freedom from redilation was high: 84% at 72 months (PA), 95% at 54 months (aorta), and 81% at 50 months (SIVC).
• Redilation further improved lumen diameter (P<0.01), with no deaths associated with stent implantation.

Conclusions:

• Percutaneous stenting with Palmaz or Palmaz Genesis stents is a common and effective procedure in Japan.
• Redilation is a valuable adjunct to stenting, improving lumen diameter.
• Procedures demonstrate low morbidity with favorable medium- and long-term follow-up outcomes for CHD patients.