Stenting of the Ductus Arteriosus as a Bridge to Cardiac Transplantation in Infants with the Hypoplastic Left-Heart Syndrome

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Abstract
The hypoplastic left-heart syndrome is a complex congenital cardiac malformation1-3 that accounts for 7 to 8 percent of all cardiac lesions presenting in the first year of life; in addition, it is known to be the most common cause of death due to cardiac causes during the first week of life3-5. The prognosis has changed substantially since the development of the Norwood procedure in 19803,6-11 and the introduction of neonatal heart transplantation in 19853,12-14. When transplantation is considered, however, patency of the ductus arteriosus must be maintained until a suitable donor organ can be found. Although alprostadil (prostaglandin E) is effective in maintaining the patency of the ductus, its prolonged use can result in serious side effects and has practical limitations15-17. Therefore, an alternative method of maintaining ductal patency is needed.