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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Pediatric Cardiology
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1395132
This article is part of the Research Topic Pediatric and Perinatal Cardiology; Insights, Advances and Updates View all 3 articles

Clinical Outcomes of Right Ventricular Outflow Tract Stenting Compared to Surgical Shunting in Late-Presenting Children

Provisionally accepted
Radityo Prakoso Radityo Prakoso *Resi Citra Dewi Resi Citra Dewi Brian Mendel Brian Mendel Celly A. Atmadikoesoemah Celly A. Atmadikoesoemah Salomo Purba Salomo Purba Damba D. Sakti Damba D. Sakti Nanda Iryuza Nanda Iryuza Yovi Kurniawati Yovi Kurniawati Renan Sukmawan Renan Sukmawan
  • National Cardiovascular Center Harapan Kita (Indonesia), Jakarta, Indonesia

The final, formatted version of the article will be published soon.

    Background: Right ventricular outflow tract (RVOT) stenting as an alternative palliation for patients with stenotic RVOTs is increasingly recognized. However, a notable gap remains in the literature regarding the efficacy and the comparative outcomes between RVOT stenting and the modified Blalock-Taussig shunt (mBTS) in children older than one year. Methods: We conducted a retrospective review of clinical data from patients aged one year to 18 years with stenotic RVOTs who underwent RVOT stenting or mBTS procedures at our institution between December 2019 and October 2022. We compared major adverse cardiovascular events (MACE) including re-hospitalization, re-intervention, and mortality, hospital and ICU length of stay, and discharge oxygen saturation between the groups. Results: We identified 58 patients (51.7% male) with a median age of 2.6 years (IQR: 2-8.1) and a median weight of 9.7 kg (IQR: 7.5-17.5). Among them, 18 (31%) patients received RVOT stenting, and 40 (68.9%) patients had mBTS. The median age for the RVOT stenting group was 92.5 months (IQR: 31.2- 152) compared to 26.5 months (IQR: 23.0-54.0) for the mBTS group (p=0.218). MACEs occurred in 4 (22.2%) patients with RVOT stents and 8 (20%) patients with mBTS (p=0.624). Patients with mBTS had a longer ICU stay (median 3.5 days, IQR, 2-5) compared to those with RVOT stents (median 2 days, IQR: 1-2) (p=0.295). Conversely, the hospital stay for patients with mBTS was shorter (median 10 days, IQR, 7.5-13.7) than for those with RVOT stents (median 11.5 days, IQR, 7-19) (p=0.045). The median discharge oxygen saturation was 87% (IQR: 83-88) in the mBTS group and 80% (IQR: 75-87) in the RVOT stenting group (p=0.212). Conclusions: RVOT stenting as palliation to stenotic RVOTs in children older than one year demonstrated outcomes comparable to mBTS in terms of MACE and achieving oxygen saturation targets.

    Keywords: Developing country, Fallot tetralogy, Late-presenter, Modified Blalock-Taussig shunt, RVOT obstruction, stent

    Received: 03 Mar 2024; Accepted: 10 Oct 2024.

    Copyright: © 2024 Prakoso, Citra Dewi, Mendel, Atmadikoesoemah, Purba, Sakti, Iryuza, Kurniawati and Sukmawan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Radityo Prakoso, National Cardiovascular Center Harapan Kita (Indonesia), Jakarta, Indonesia

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