Prosthetic conduits, with or without
biological valves, are often inserted in
surgical procedures to correct or palliate cardiac malformations. The principal problem is degeneration which causes variable degrees of obstruction requiring reoperation for their replacement. The aims of this study were to assess the feasibility, safety and efficacy of a non-surgical method of treating these obstructive
prostheses by dilatation-implantation of a metallic vascular
endoprosthesis (stenting). Thirteen patients were treated (age range 7.7 to 36 years; mean: 15 years). Eight had
pulmonary atresia with a
ventricular septal defect corrected by a valved conduit from the right ventricle to the pulmonary artery which became obstructive nearly 10 years later: the implantation of the
stent reduced the transconduit pressure gradient in all cases except one who had not undergone closure of the septal defect in which the
cyanosis was improved. There are two cases of obstruction of a modified Blalock anastomosis in which the
stent revascularised the shunt with improvement in
cyanosis. In the final 3 cases, the whole
Fontan procedure was compromised by obstruction of a conduit incorporated in the system, and which dilatation with stenting considerably improved. The efficacy of the procedure was constant with no complications other than
rupture of the balloon in 3 cases. The good results were maintained for an average of 7.3 months (range 1 to 25 months), but it was necessary to redilate one restenosed
stent after 8 months. Dilatation followed by stenting in obstructive cardiovascular
prostheses is a simple, safe and effective alternative to surgical reoperation.