First case of simultaneous hybrid stenting of obstructedaortic arch and left pulmonary artery stenosis in patientafter Norwood I

Authors: M.G. Pursanov, D.O. Berishvili, A.V. Sobolev, I.E. Nefedova, D.V. Lyazin, S.V. Kalashnikov, O.A. Stepanicheva, A.O. Baveyan

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery of Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

Cite as: Pursanov M.G., Berishvili D.O., Sobolev A.V., Nefedova I.E., Lyazin D.V., Kalashnikov S.V., Stepanicheva O.A., Baveyan A.O. First case of simultaneous hybrid stenting of obstructed aortic arch and left pulmonary artery stenosis in patient after Norwood I. Children’s Heart and Vascular Diseases. 2018; 15 (3): 175–81 (in Russ.). DOI: 10.24022/1810-0686-2018-15-3-175-181

Received / Accepted: 31.01.2018/01.02.2018

Keywords: stenting hybrid stenting aortic hybrid stenting pulmonary artery neo-aorta aortic arch hypoplastic left heart syndrome congenital heart defects Norwood I

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Abstract

Neoaortic arch narrowing and pulmonary artery (PA) stenosis as iatrogenic complications developing after staged surgical corrections in patients with hypoplastic left heart syndrome (HLHS) are main complication factors which are preventing further complete repair. To address these complications hybrid procedures are being developed to eliminate obstruction with stenting. We present first clinical case of simultaneous hybrid stenting of the neoaortic arch narrowing, PA stenosis and hypoplasia and surgical palliative procedure with replacement of Blalock anastomosis in patient 1 year 10 month old and weight 8 kg after Norwood I procedure. Neoaortic arch was performed using 10 Fr introducer, placed in ascending aorta. We implanted “Intrastent LD Max” 26 mm length, which was mounted on 14 ×30 mm “BiB” balloon catheter. Stenting of the left PA was performed using 6 ×18 mm “Valeo” stent, implanted using 7 Fr introducer in distal stump of the systemic-pulmonary anastomosis. We believe that this hybrid stenting approach is perspective method of treatment allowing simultaneous, effective and safe management of the different pathology of various vascular pools, developed after Norwood I procedure in patients with HLHS.

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About the authors

Manolis G. Pursanov, Dr Med. Sc., Head of Department, orcid.org 0000-0002-1421-1795;
David O. Berishvili, Dr Med. Sc., Head of Department, orcid.org/0000-0001-7379-345X;
Andrey V. Sobolev, Cand. Med. Sc., Leading Researcher, orcid.org/0000-0002-0186-8165;
Inessa E. Nefedova, Cand. Med. Sc., Head of Department, orcid.org/0000-0002-9221-051X;
Denis V. Lyazin, Cardiovascular Surgeon, Junior Researcher, orcid.org/0000-0002-3499-8281;
Sergey V. Kalashnikov, Junior Researcher, orcid.org/0000-0003-2575-6691;
Ol’ga A. Stepanicheva, Anesthesiologist-Intensivist, orcid.org/0000-0003-0430-6157;
Ashot O. Baveyan, Postgraduate, orcid.org/0000-0001-5093-4977

Chief Editor

Konstantin V. Shatalov
MD, PhD, DSc, Professor
Bakoulev National Medical Research Center for Cardiovascular Surgery

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