Recanalization of Occluded or Severely Stenotic Ilio-femoral Veins in Infants: Use of Express Vascular LD Stents

Pediatric Cardiology and Cardiac Surgery
Vol.27 No.6 2011 (270-274)

Takahiro Nishioka^1）, Hideshi Tomita^2）, Madoka Sawada^1）, Takashi Matsuoka^1）, Takashi Soga^1）, Yousuke Kuroko^2）,Yoko Yamabe^2）, Atsushi Ito^2）, Kozo Ishino^2） Shigeru Uemura^2）

Showa University Northern Yokohama Hospital, ^1）Children’s Medical Center, ^2）Cardiovascular Center, Yokohama, Japan

Abstract

We report cases of recanalization of ilio-femoral veins (IFV) using stents in infants. Case1 is a 4-month-old girl presented with pulmonary venous obstruction (PVO) complicating intracardiac repair of total anomalous pulmonary venous connection (TAPVC) Ia. After intracardiac repair of TAPVC at 14 days, she developed PVO after surgery. Despite atrial septal defect (ASD) creation, at 2 month .she developed PVO again at 3 months. Stents were implanted in the bilateral PVs. One month later, we found an occluded right iliac vein. We implanted 2 stents in the right IFV. Because of restenosis, we implanted a third stent at 7 months of age. Case2 is a 19-month-old girl presented with double outlet right ventricle, ventricular septal defect (DORV), partial anomalous pulmonary venous connection (PAPVC), and patent ductus arteriosus (PDA) complicated by left congenital cystic adenomatoid malformation (CCAM) and pulmonary sequestration. We performed a lobectomy, followed by PDA ligation and pulmonary artery banding at 1 month; because hypoxia progressed at 17 months,an atrial septal defect was created by the transcatheter method, followed by stent implantation in the atrial septal defect 2 months later. Severe stenosis was detected in the right IFV. We implanted 2 stents. Follow-up echocardiography confirmed good blood flow. Transcatheter recanalization for stenosis of the IFV using stents is feasible in infants. Further evaluation is needed.