{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T02:10:12Z","timestamp":1740103812455,"version":"3.37.3"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T00:00:00Z","timestamp":1640822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The optimal management pathway for the dysfunctional right ventricular outflow tract (RVOT) is uncertain. We evaluated the long\u2010term outcomes and clinical impact of stent implantation for obstructed RVOTs in an era of rapidly progressing transcatheter pulmonary valve technology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review of 151 children with a biventricular repair who underwent stenting of obstructed RVOT between 1991 and 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>RVOT stenting resulted in significant changes in peak right ventricle (RV)\u2010to\u2010pulmonary artery (PA) gradient (39.4\u2009\u00b1\u200917.1\u201314.9\u2009\u00b1\u20098.3; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and RV\u2010to\u2010aortic pressure ratio (0.78\u2009\u00b1\u20090.22\u20130.49\u2009\u00b1\u20090.13; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Subsequent percutaneous reinterventions in 51 children to palliate recurrent stenosis were similarly effective. Ninety\u2010nine (66%) children reached the primary outcome of subsequent pulmonary valve replacement (PVR). Freedom from PVR from the time of stent implantation was 91%, 51%, and 23% at 1, 5, and 10 years, respectively. Small balloon diameters for stent deployment were associated with shorter freedom from PVR. When additional children without stent palliation (with RV\u2010to\u2010PA conduits) were added to the stent cohort (total 506 children), the multistate analysis showed the longest freedom from PVR in those with stent palliation and subsequent catheter reintervention. Pulmonary regurgitation was well\u2010tolerated clinically. Indexed RV dimensions and function estimated by echocardiography remained stable at last follow up or before primary outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Prolongation of conduit longevity with stent implant remains an important strategy to allow for somatic growth to optimize the risk\u2010benefit profile for subsequent surgical or transcatheter pulmonary valve replacement performed at an older age.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30043","type":"journal-article","created":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T09:03:37Z","timestamp":1640855017000},"page":"1138-1148","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Is there a role for endovascular stent implantation in the management of postoperative right ventricular outflow tract obstruction in the era of transcatheter valve implantation?"],"prefix":"10.1002","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1556-7395","authenticated-orcid":false,"given":"Sok\u2010Leng","family":"Kang","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology Alder Hey Children's Hospital Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronand","family":"Ramroop","sequence":"additional","affiliation":[{"name":"Department of Paediatric Medicine, Wendy Fitzwilliam's Childrens' Hospital Eric Williams Medical Sciences Complex  Trinidad and Tobago West Indies"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larissa","family":"Manojlovich","sequence":"additional","affiliation":[{"name":"The Department of Pediatrics, Division of Cardiology, The Labatt Family Heart Center, The Hospital for Sick Children University of Toronto School of Medicine Toronto Ontario 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