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lüll Implantation of endovascular stents for the obstructive right ventricular outflow tract Sugiyama H; Williams W; Benson LNHeart 2005[Aug]; 91 (8): 1058-63OBJECTIVES: To evaluate the effectiveness and long term outcomes of catheter intervention for obstructive conduits between the right ventricle and pulmonary arteries. DESIGN: Retrospective chart review. SETTING: Tertiary care paediatric cardiology unit. PATIENTS AND INTERVENTIONS: 70 procedures in 68 children (median age at intervention 6 years, median interval after conduit insertion 3.4 years) were analysed. All children had haemodynamic indications for conduit replacement. Twenty four children underwent a second intervention (stent dilatation in 17, second stent implantation in seven). RESULTS: Mean (SD) conduit pressure gradient decreased from 44 (18) mm Hg to 18 (12) mm Hg at the initial intervention (n = 62, p < 0.001) and from 39 (15) mm Hg to 23 (10) mm Hg at the second intervention (n = 16, p < 0.001). The percentage of the predicted right ventricular outflow area increased from 17 (9)% to 44 (22)% at the initial intervention (n = 62, p < 0.001) and from 24 (8)% to 29 (11)% at the second intervention (n = 21, p < 0.001). The conduit was subsequently replaced in 33 children. Freedom from conduit replacement from the time of stent implantation was 83%, 75%, and 47% at one, two, and five years, respectively, and from the time of the initial conduit surgery it was 87%, 64%, and 42% at five, eight, and 10 years, respectively. Body growth was maintained, no deaths were reported during follow up, and pulmonary insufficiency was well tolerated. CONCLUSION: A catheter treatment strategy for obstructive conduits is safe and effective in prolonging conduit function.|*Blood Vessel Prosthesis[MESH]|*Heart Defects, Congenital[MESH]|*Stents[MESH]|Adolescent[MESH]|Blood Vessel Prosthesis Implantation/*methods[MESH]|Cardiac Catheterization/*methods[MESH]|Catheterization/*methods[MESH]|Child[MESH]|Coronary Angiography[MESH]|Female[MESH]|Follow-Up Studies[MESH]|Hemodynamics[MESH]|Humans[MESH]|Male[MESH]|Retreatment[MESH]|Retrospective Studies[MESH]|Survival Analysis[MESH]|Ventricular Outflow Obstruction/physiopathology/*therapy[MESH] |