Right Ventricular Outflow Tract Stenting as Palliation of Critical Tetralogy of Fallot: Techniques and Results

Background. Despite current trends toward early primary repair, the surgical systemic-to-pulmonary shunt is still considered first-choice palliation in patients with critical tetralogy of Fallot (TOF) and duct-dependent pulmonary circulation unsuitable for repair. However, stenting right ventricular outflow tract (RVOT) nowadays emerging as an effective alternative to selected patients. Methods results. RVOT usually performed from a venous route, either femoral or, cases, internal jugular vein. Less frequently, mostly infundibular/valvar atresia, this procedure can be using hybrid surgical/interventional approach by exposure RVOT, puncture atretic valve, stent deployment under direct vision. The size type most appropriate may chosen, based on ultrasound measurements cover infundibulum completely and, at same time, sparing unless significant valve annulus hypoplasia and/or supra-valvular stenosis component obstruction. In large series so far published, mortality less than 2%, comparing favourably Blalock-Thomas-Taussig or addition, morbidity clinical sequelae do not significantly differ palliation, even if shows lesser durability higher rate trans-catheter re-interventions over mid-term follow-up. Finally, similar but more balanced artery growth following reported Conclusions. technically feasible, well-tolerated, TOF. This cost-effective respect high-risk neonates whenever short-term blood flow source anticipated due It effectively increases flow, improves arterial saturation, promotes