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European Heart Journal Advance Access published online on October 17, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl328
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European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received January 13, 2005
Revised September 22, 2006
Accepted September 28, 2006

Clinical research

Early complications of stenting in patients with congenital heart disease: a multicentre study

Menno van Gameren 1, Maarten Witsenburg 1 *, Johanna J.M. Takkenberg 2, Derize Boshoff 3, Luc Mertens 3, Anton M. van Oort 4, Daniël de Wolf 5, Matthias Freund 6, Narayanswani Sreeram 7, Regina Bökenkamp 8, Melle D. Talsma 9, and Marc Gewillig 3

1 Department of Paediatric Cardiology, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands
2 Department of Cardio-Thoracic Surgery, Erasmus MC, Rotterdam, The Netherlands
3 Department of Paediatric Cardiology, University Hospital Leuven, Belgium
4 Department of Paediatric Cardiology, University Hospital Nijmegen, The Netherlands
5 Department of Paediatric Cardiology, University Hospital Gent, Belgium
6 Department of Paediatric Cardiology, Utrecht University Medical Centre, The Netherlands
7 Department of Paediatric Cardiology, University Hospital Cologne, Germany
8 Department of Paediatric Cardiology, Leiden University Medical Centre, The Netherlands
9 Department of Paediatric Cardiology, University Hospital Groningen, The Netherlands

* To whom correspondence should be addressed.
Maarten Witsenburg, E-mail: m.witsenburg{at}erasmusmc.nl


  Abstract

Aims Stenting has become an established interventional cardiology procedure for congenital heart disease. Although most stent procedures are completed successfully, complications may occur. This multicentre study evaluated early complications after stenting in patients with congenital heart disease, including potential risk factors.

Methods and results In this combined Dutch-Belgian retrospective study, 309 consecutive patients had undergone 366 catheterizations and received 464 stents in 13 different anatomical positions (418 sites). Seventy-two stenting-related complications (19%) occurred, of which 24 (5.7%) were major. Seven procedure-related deaths were documented (2.3%). Stent malpositioning and embolization were most common (7.7%). The use of non-premounted stents tended to be associated with higher complication rates. Centre inexperience with stenting and stenting of native vs. post-surgical stenosis tended to be associated with increased major complication rates.

Conclusion After stenting, complications are common for congenital heart disease. The vast diversity of stenotic sites combined with relatively small patient populations makes these procedures sensitive to complications. Combining operator experience may reduce the risks of stenting in congenital heart disease. The availability of premounted stents for greater vessel diameters will likely reduce incidences of stent migration and embolization.

Keywords: Stents; Interventional catheterization; Congenital heart disease; Paediatrics; Complications.
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