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El síndrome de Wolff Parkinson White ocurre por la presencia de vías accesorias que comunican anormalmente las aurículas con los ventrículos, es una de las principales causas de taquicardia paroxística supraventricular en jóvenes y adolescentes, en quienes el manejo ideal es la ablación con catéter. Este síndrome también puede presentarse en pacientes de menor edad como neonatos y lactantes, en donde las opciones terapéuticas son distintas. Presentamos el caso de una paciente de 47 días de vida que ingresó a un hospital pediátrico público de Perú presentando vómitos, a su ingreso mostró una frecuencia cardiaca de 250 latidos por minuto; se logró documentar taquicardia de complejos QRS anchos; posteriormente, en el electrocardiograma en ritmo sinusal, se evidenció signos de preexcitación

BackgroundThe implantation of stents to keep the ductus arteriosus patent in cyanotic congenital heart disease is an alternative to the modified Blalock-Taussig surgery (mBT) in high-risk patients. This study describes the immediate and medium-term outcomes of stent implantation in neonates and infants with duct-dependent pulmonary circulation.MethodsThis was a descriptive and prospective study including different cyanotic congenital heart diseases treated between 2014 and 2015.ResultsFourteen patients with a mean age of 46 days, and mean weight of 4.5kg were assessed, and pulmonary artresia with interventricular communication was the most treated condition. The femoral artery approach was used in 70% of procedures; carotid approach was used in the remaining cases. Stents of 3.5 x 12mm were used in most cases, and implant success was achieved in 78% of interventions (11/14). The failed cases were referred to surgery – one of them was an emergency, which resulted in death. Ductal spasm occurred in < 48hours in three patients who required mBT, with favorable outcome. Complications after discharge and within the first 30 days included stent thrombosis (2/11), one of which was controlled with redilation, another progressed to death, and one sudden death (1/11). The overall mortality was 21.4% (3/14). A patent ductus arteriosus in the first 6 months was present in five cases, which underwent palliative surgery.ConclusionsThe initial experience of ductal stenting showed favorable immediate outcomes, but in the medium term, little more than a third of the cases maintained a patent ductus arteriosus within 6 months.

RESUMOIntroduçãoO implante de stents para manter o ducto arterial patente na cardiopatia congênita cianótica é uma alternativa à cirurgia de Blalock‐Taussig modificada (BTm) em pacientes de alto risco. Descrevemos os resultados imediatos e de médio prazo do implante de stent em neonatos e lactentes com circulação pulmonar ducto‐dependente.MétodosTrata‐se de estudo descritivo e prospectivo, que incluiu diferentes cardiopatias congênitas cianóticas tratadas entre 2014 e 2015.ResultadosAvaliamos 14 pacientes, com média de idade de 46 dias e pesando 4,5kg, sendo a atresia pulmonar associada à comunicação interventricular a cardiopatia mais tratada. A abordagem pela artéria femoral ocorreu em 70% dos procedimentos e, nos demais, por via carotídea. Stents de 3,5 12mm foram usados na maioria dos casos, e o sucesso do implante foi obtido em 78% das intervenções (11/14). Os casos de insucesso foram encaminhados para cirurgia uma delas em situação de urgência, que resultou em óbito. Ocorreu espasmo ductal < 48 horas em três pacientes que necessitaram de BTm, com evolução favorável. Complicações após a alta e nos primeiros 30 dias incluíram trombose de stent (2/11), uma delas controlada com redilatação e outra que evoluiu para óbito, e uma morte súbita (1/11). A mortalidade total foi de 21,4% (3/14). A patência do ducto arterial nos primeiros 6 meses foi obtida em 5 casos que foram submetidos à cirurgia paliativa.ConclusõesA experiência inicial de implante de stent ductal mostrou resultados imediatos favoráveis, e, em médio prazo, mais de um terço dos pacientes com circulação pulmonar ducto‐dependente manteve seus canais patentes.ABSTRACTBackgroundThe implantation of stents to keep the ductus arteriosus patent in cyanotic congenital heart disease is an alternative to the modified Blalock‐Taussig surgery (mBT) in high‐risk patients. This study describes the immediate and medium‐term outcomes of stent implantation in neonates and infants with duct‐dependent pulmonary circulation.MethodsThis was a descriptive and prospective study including different cyanotic congenital heart diseases treated between 2014 and 2015.ResultsFourteen patients with a mean age of 46 days, and mean weight of 4.5kg were assessed, and pulmonary artresia with interventricular communication was the most treated condition. The femoral artery approach was used in 70% of procedures; carotid approach was used in the remaining cases. Stents of 3.5 x 12mm were used in most cases, and implant success was achieved in 78% of interventions (11/14). The failed cases were referred to surgery – one of them was an emergency, which resulted in death. Ductal spasm occurred in < 48hours in three patients who required mBT, with favorable outcome. Complications after discharge and within the first 30 days included stent thrombosis (2/11), one of which was controlled with redilation, another progressed to death, and one sudden death (1/11). The overall mortality was 21.4% (3/14). A patent ductus arteriosus in the first 6 months was present in five cases, which underwent palliative surgery.ConclusionsThe initial experience of ductal stenting showed favorable immediate outcomes, but in the medium term, little more than a third of the cases maintained a patent ductus arteriosus within 6 months.