Background:Patients with single ventricle anatomy and ductal-dependent pulmonary blood flow may be initially palliated with either modified Blalock-Taussig shunt (BTS) or ductus arteriosus stent (DAS). Comparisons of outcomes during the interstage period and at the time of superior cavopulmonary connection (SCPC) are lacking and may differ between palliation strategies.Methods:Infants with single ventricle anatomy and ductal-dependent pulmonary blood flow palliated with either DAS or BTS from 2008 to 2015 were reviewed across 4 centers. Interstage outcomes, and for those who had SCPC, anatomy, hemodynamics, and perioperative clinical outcomes were compared. Thirty-five patients with DAS and 136 patients with BTS were included.Results:At initial palliation, demographic, clinical variables, and pulmonary artery size were similar. Interstage death, transplant, or unplanned reintervention to treat cyanosis occurred in 25.7% of DAS and 35.8% of BTS, P=0.27. Reintervention was more common with DAS (48.6% versus 2.2%; P<0.001). Twenty-three DAS patients and 111 BTS patients underwent SCPC. Preoperative hemodynamics and overall pulmonary atresia growth were similar, although right pulmonary artery growth was better with DAS (change in z-score: 1.57 versus 0.65, P=0.026). SCPC intraoperative and postoperative courses were similar.Conclusions:In patients with single-ventricle anatomy and ductal-dependent pulmonary blood flow, interstage outcomes, hemodynamics before SCPC, and acute postoperative outcomes were similar. Overall reintervention was more common in the DAS group, driven by more frequent planned reintervention. Unplanned reintervention, death, and transplant were similar. Both groups demonstrated good pulmonary atresia growth. DAS is a reasonable initial palliative alternative to BTS in select patients.

中文翻译：

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最初伴有Blalock-Taussig分流或动脉导管狭窄的导管依赖型肺血流的单心室患者在上腔静脉连接时的结果比较：先天性导管研究的合作结果。

背景：具有单心室解剖结构和导管依赖性肺血流的患者可首先采用改良的Blalock-Taussig分流器（BTS）或动脉导管支架（DAS）缓解。缺乏阶段间和上腔静脉连接（SCPC）时结局的比较，并且可能在缓解策略上有所不同。对4个中心的2015年进行了回顾。比较了阶段间的结果以及那些患有SCPC的患者的解剖学，血液动力学和围手术期的临床结果。结果：35例DAS患者和136例BTS患者被纳入研究。结果：在最初的缓解时，人口统计学，临床变量和肺动脉大小相似。阶段间死亡P＝ 0.27。DAS的再干预更为常见（48.6％对2.2％；P <0.001）。对23例DAS患者和111例BTS患者进行了SCPC。术前血流动力学和总体肺动脉闭锁的生长相似，尽管DAS可使右肺动脉生长更好（z评分的变化：1.57对0.65，P= 0.026）。结论：在单心室解剖学和导管依赖性肺血流的患者中，期间结局，SCPC之前的血流动力学和急性术后结局相似。在计划中的更频繁干预的推动下，DAS组中的总体再干预更为普遍。计划外的再干预，死亡和移植相似。两组均表现出良好的肺动脉闭锁性生长。在选定的患者中，DAS是BTS的合理初始姑息替代药物。