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Bronchus compression relieved by patent ductus arteriosus stenting

Wagih M Zayed1, Krishna Bhandari1, Peter W Guyon1

  • 1Division of Pediatric Cardiology, Rady Children's Hospital and UC San Diego School of Medicine, San Diego, California.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|September 14, 2020
PubMed

Insights

Patent ductus arteriosus (PDA) stenting can relieve bronchial compression in infants. This procedure improved airway compression in patients with ductal-dependent pulmonary blood flow, showing PDA stenting is a viable option.

Area of Science:

  • Pediatric Cardiology
  • Interventional Cardiology
  • Thoracic Surgery

Background:

  • Patent ductus arteriosus (PDA) stenting is an emerging alternative to surgical shunts for ductal-dependent pulmonary blood flow in infants.
  • Anatomical proximity of PDA can lead to ipsilateral bronchial compression.
  • This case series investigates PDA stenting in patients with pre-existing bronchial compression.

Purpose of the Study:

  • To evaluate the efficacy of PDA stenting in infants with bronchial compression.
  • To assess the impact of PDA stenting on relieving airway compression.
  • To identify factors influencing bronchial compression related to PDA characteristics.

Main Methods:

  • Retrospective review of four infants with ductal-dependent pulmonary blood flow and bronchial compression who underwent PDA stenting.
  • Analysis of pre- and post-procedure cross-sectional chest imaging.
  • Assessment of PDA size, tortuosity, and anatomical relationship with the bronchus.

Main Results:

  • Post-procedure imaging in three patients showed complete relief of bronchial compression.
  • Successful PDA stenting resulted in a smaller, straighter PDA with lateralization away from the bronchus.
  • No patients developed symptoms of bronchial compression after the procedure.

Conclusions:

  • Pre-existing bronchial compression does not contraindicate PDA stenting.
  • PDA stenting effectively improves pre-existing bronchial compression, likely due to PDA shrinkage, straightening, and lateralization.
  • Further research is warranted to validate these findings.
Abstract

Keywords:
PDA stentbronchial compressionbronchial narrowingcongenital heart diseaseductal dependent pulmonary blood flowpulmonary atresia

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