Balloon-expandable stents for recoarctation of the aorta in small children. Two centre experience

Gendera, Katarzyna; Ewert, Peter; Tanase, Daniel; Georgiev, Stanimir; Genz, T.; Heck, Pinar Bambul; Moszura, Tomasz; Malčić, Ivan; Cleuziou, Julie; Eicken, Andreas

doi:10.1016/j.ijcard.2018.02.054

Cited by 19 publications

(22 citation statements)

References 27 publications

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“…Although even stents delivered through a 6F coronary guiding catheter may not be dilatable to adult size, they may be very well cracked later in life to achieve adult-sized vessel or valve dimensions. 7 Arterial duct stenting aims to establish a reliable source of pulmonary blood flow. According to current indications for cardiac catheterisation in paediatric patients, 5 access vessel injury or obstruction is particularly mentioned as potential risks or complication of the procedure.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous catheter interventions via Glidesheath Slender in small children

et al. 2020

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Background: Catheterization in small children should be performed with the lowest diameter introducer sheaths to prevent permanent vessel damage. The objective of this study is to evaluate the clinical safety and efficacy of the Glidesheath Slender in small children. Methods and results: We present a group of 52 patients (male: n = 36) with median age 118.5 days (min. 3; max. 1302), median weight: 5.3 kg (min. 1.4; max. 14.0), median height: 60.5 cm (min. 39; max. 102), and median body surface area 0.28 m2 (min. 0.12; max. 0.63) in whom percutaneous catheter interventions (n = 55) were performed via a Glidesheath Slender. In 49 children, the intervention was performed from femoral access (artery n = 35; vein n = 14) in 2 from the axillary arterial access and in 1 from the jugular venous access. In all patients, the vessel access was obtained under ultrasound guidance. After the catheterization, the pulse on the peripheral arteries (posterior tibial artery or radial artery) was palpable in all patients, and no signs for vessel dysfunction were present. Conclusion: The Glidesheath Slender effectively reduces the outer sheath diameter for various types of interventions in small children by one French, reducing the risk of vessel complications (stenosis, occlusion). Interventions via Glidesheath Slender in small patients are safe and feasible and extend the transcatheter possibilities in small children with congenital heart diseases.

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Section: Discussionmentioning

confidence: 99%

Percutaneous catheter interventions via Glidesheath Slender in small children

et al. 2020

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“…There are 2 general types of stents: a balloon expandable intravascular stent and self-expandable intravascular stent. A balloon expandable stent has become an integral part of the treatment of intravascular stenosis among children and adults with congenital heart disease, and it has successfully been used to manage and treat a variety of vascular stenoses such as pulmonary artery stenosis, coarctation of the aorta, arterial duct, postoperative systemic to pulmonary shunt, and RV-PA conduit 11)12)13). However, despite the benefits of balloon expandable stent implantation in congenital heart disease, some problems may arise when used in children.…”

Section: Discussionmentioning

confidence: 99%

Self-Expandable Stents in Vascular Stenosis of Moderate to Large-Sized Vessels in Congenital Heart Disease: Early and Intermediate-Term Results

Jang

2019

Korean Circ J

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Background and ObjectivesVascular stenosis after surgical repair frequently occurs in congenital heart disease. Although conventional balloon dilation is a useful option for stenotic lesions, restenosis may occur. Consequently, balloon expandable stents have been used; however, there are a limited number of balloon expandable stents in our country. Here, we report the early and intermediate-term outcomes of self-expandable stents in vascular stenosis of moderate to large-sized vessels in congenital heart disease.MethodsTwelve self-expandable stents were implanted in 9 patients between February 2012 and January 2019. The median age and weight were 12 years (range, 4–39 years) and 38 kg (range, 19–69 kg), respectively. The patients were followed-up for a median duration of 43 months (range, 1–83 months) after stent implantation.ResultsNine self-expandable stents were implanted in the pulmonary artery, 2 stents in the right ventricle to the pulmonary artery conduit, and 1 stent in the coarctation. The narrowest diameter of the stented vessel increased from 5.7±3.2 mm to 12.6±3.4 mm (p<0.05). The mean pressure gradient across the stenotic lesion decreased from 23.0±28.2 mmHg to 3.2±3.6 mmHg (p<0.05). Distal migration of the stent occurred in 1 patient, and significant neointimal ingrowth was noted in 1 patient.ConclusionsThe self-expandable stent may be a useful option to relieve vascular stenosis in moderate to large-sized vessels with acceptable intermediate-term outcomes.

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“…Coarctation of the aorta (CoA) is an unusual congenital heart defect, which accounts for 5-8% in all congenital heart diseases (1)(2)(3). The most commonly associated intracardiac defect of CoA is the ventricular septal defect (VSD) (4,5).…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Surgical Repair for Coarctation of the Aorta With Intracardiac Defects: A Single Center Experience Based on 93 Infants

et al. 2020

Front. Pediatr.

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Introduction: This study aims to summarize the clinical characteristics of coarctation of the aorta (CoA) associated with intracardiac anomalies in infants. Methods: Medical records of 93 infants who were diagnosed with CoA and intracardiac anomalies from August 2009 to August 2018 were retrospectively reviewed. Results: All of the 93 infants underwent single-stage repair for CoA associated with intracardiac anomalies. The mean operative time was 264.6 ± 57.1 min, and the time of ICU stay was 7.0 ± 4.1 days. The residual transcoarctation pressure gradient before discharge was lower than the pressure gradient prior to surgery (48.3 ± 17.5 vs. 22.4 ± 9.6 mmHg, P < 0.01). Early death before discharge was found in five infants. The mean follow-up time of 88 hospital survivors was 40.0 ± 26.4 months, and no subsequent death occurred in the follow-up. Transcoarctation pressure gradient of the 88 survivors in their last follow-up was 19.6 ± 10.5 mmHg. The pressure gradient of 27 cases was higher than 20 mmHg. Significant lower limb retardation was observed in four cases; therefore, balloon angioplasty consult was recommended. The cumulative recoarctation-free survival rate in 3-year follow-up was 73.5%. Conclusions: To avoid secondary operations in early period, single-stage repair of CoA associated with intracardiac anomalies was effective and safe, and the outcomes in early to mid-term follow-up were satisfactory.

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Balloon-expandable stents for recoarctation of the aorta in small children. Two centre experience

Cited by 19 publications

References 27 publications

Percutaneous catheter interventions via Glidesheath Slender in small children

Percutaneous catheter interventions via Glidesheath Slender in small children

Self-Expandable Stents in Vascular Stenosis of Moderate to Large-Sized Vessels in Congenital Heart Disease: Early and Intermediate-Term Results

Diagnosis and Surgical Repair for Coarctation of the Aorta With Intracardiac Defects: A Single Center Experience Based on 93 Infants

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