PDA stent better than APS for initial palliation in patients with congenital heart disease: JAHA

USA: In cyanotic congenital heart disease with ductal-dependent pulmonary blood flow, a patent ductus arteriosus (PDA) stent is associated with fewer complications and a shorter length of hospital stay than aortopulmonary shunt (APS). Also, there was a significant difference in mortality or unplanned reinterventions, states an article published in The Journal of the American Heart Association.

In patients with cyanotic congenital heart disease (CHD) and ductal‐dependent pulmonary blood flow (DDPBF) establishing a stable source of pulmonary blood flow using palliative techniques is crucial. Palliative techniques help to "buy time" until the subsequent definitive repair is performed and survival may depend on its design. Historically, this was achieved through a surgical aortopulmonary shunt (APS) but there was a significant risk of morbidity and mortality with this surgical procedure. Over the last decade, PDA stent has emerged as a viable alternative to APS. It is a less invasive approach and recovery is faster. Nevertheless, PDA stent also carries risks of procedural complications and increased need for reinterventions

Stephanie Y., Cincinnati Children's Hospital Medical Center, OH, USA, and her team conducted a meta‐analysis to compare mortality risk and clinical outcomes after the use of PDA stent and APS, as initial palliation in patients with ductal‐dependent pulmonary blood flow.

The research team performed a comprehensive search from PubMed and Embase databases which yielded six retrospective observational studies that met inclusion criteria. Pooled adjusted hazard ratios (HR) were included to control for covariates and assess time to event analysis. Of 757 patients, 243 (32.1%) underwent PDA stent and 514 (67.9%) underwent APS.