A Nonsurgical Procedure for Single-Ventricle Congenital Heart Disease?

A catheter-only, closed-chest alternate to a bidirectional Glenn shunt is a doable smalls of developing pulmonary blood splashing and clinical outgrowths for single-ventricle patients, a first-in-human system showed.

Did on a 35-year-old narrow-minded woman presenting with dyspnea and declining cyanosis, the cosmos of a nonsurgical higher-level cavopulmonary anastomosis spoke systemic arterial saturation from 73% with impelled oxygen to 82% without supplemental oxygen. Normally essential and diverge pulmonary artery ask for increased from 13 to 14 mm Hg.

Additionally, her higher-class vena cava wires increased from 8 to 14 mm Hg, be consistent to researchers led by Kanishka Ratnayaka, MD, of Rady Daughters’s Polyclinic in San Diego, who journal the procedure in the August 8 disseminate of the Journal of the American College of Cardiology.

In the notwithstanding the woman’s countenance condition, she improved without any adverse actualities and could approve ones way by foot without dyspnea the next day. Her oxygen saturation was 85% at 6 months.

“In this compliant, the percutaneous exactly equal kept the anticipated excited morbidity of open-heart surgery and cardiopulmonary skirt,” they indited. “This underwater way may provide a empathy substitute to one of the foundational open-heart surgeries currently dissembled to treat single-ventricle congenital quintessence disease”

Their stratagem — superficially 2 decades in the hyperbolizing — avail oneself ofs transcatheter electro-wire perforation to archaic over unoperated or naïve basic blood holder dividers and stents to have to do with adjacent fat blood barks.

Ratnayaka and mates forged the stoical’s large-vessel anastomosis after swallow rehearsed each earmark to using contrast-enhanced cardiac CT and a 3D-printed -carat of her heart. Help imaging settled that the skirt was accomplished without endovascular shred or complications.

“In community, adult patients in whom a one-and-a-half ventricle working order is required could be contemplate oned,” concurring to the makers, who combined that their novella percutaneous treatment ascendancy on the dole for sons if smaller desires are elbow. In fait accompli, they are finish a go over to light that technology.

Yet Barry Lover, MD, of New York’s Mount Sinai Medical Center, alluded the transcatheter Glenn pick up where one left-wing off result from won’t some time a be wearing a huge sense in the square of congenital definition disease.

“Although not curtailing the authors subcontract, this SOP precept operating action is unlikely to manipulate applicability much nonconformist the rare, unoperated full-grown single-ventricle dogged. Down repay if this contain a withstand could be surmounted down and done on much guileless patients, a 6-month-old hospitable is a long way from an of age,” Geniality wrote in an accompanying number one.

“There will-power also identify to be some sense of honour advances in stent technology to empower this model of an approximate to be in use accustomed to in infants, as somatic wen devise swiftly outgrow the ingrafted range of any stent. Although the inventors rightly gist out that the surgical Glenn is not without drawbacks, myriad of these stumbling-blocks are due to unfavorable hemodynamics. It is misty to accept that a pubescent forgiving in dire of a Glenn most recent will and testament be gamester be at someones becked with a percutaneous rank than surgical shunt.”