کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5981976 1577003 2016 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Procedural Success and Adverse Events in Pulmonary Artery Stenting: Insights From the NCDR
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Procedural Success and Adverse Events in Pulmonary Artery Stenting: Insights From the NCDR
چکیده انگلیسی

BackgroundRisk factors associated with outcomes for pulmonary artery (PA) stenting remain poorly defined.ObjectivesThe goal of this study was to determine the effect of patient and procedural characteristics on rates of adverse events and procedural success.MethodsRegistry data were collected, and 2 definitions of procedural success were pre-specified for patients with biventricular circulation: 1) 20% reduction in right ventricular pressure or 50% increase in PA diameter; and 2) 25% reduction in right ventricular pressure or 50% decrease in PA gradient or post-procedure ratio of in-stent minimum to pre-stent distal diameter >80%. A separate definition of procedural success based on normalization of PA diameter was pre-specified for patients with single ventricle palliation.ResultsBetween January 2011 and January 2014, a total of 1,183 PA stenting procedures were performed at 59 institutions across 1,001 admissions; 262 (22%) procedures were performed in patients with a single ventricle. The rate of procedural success was 76% for definition 1, 86% for definition 2, and 75% for single ventricle patients. In the multivariate analysis, ostial stenosis was significantly associated with procedural success for biventricular patients according to both definitions. The overall complication rate was 14%, with 9% of patients experiencing death or a major adverse event (MAE). According to multivariate analysis, weight <4 kg, having a single ventricle, and emergency status were significantly associated with death or MAEs.ConclusionsIn our analysis, success was >75% across all definitions, and adverse events were relatively common. Biventricular patients with an ostial stenosis had a higher probability of a successful outcome. Patients who had a single ventricle, weight <4 kg, or who underwent an emergency procedure had a higher risk of death or MAE. These findings may help inform patient selection for PA stenting.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of the American College of Cardiology - Volume 67, Issue 11, 22 March 2016, Pages 1327-1335
نویسندگان
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