Ductal Stenting for Acute Thrombosis of Modified Blalock-Taussig Shunts

Zabala-Argüelles, Juan Ignacio; Conejo-Muñoz, Lourdes; Cuenca-Peiró, Victorio; Gil-Jaurena, Juan-Miguel

doi:10.1016/s1885-5857(10)70239-5

Cited by 1 publication

(2 citation statements)

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“…Results showed that stent implantation is an effective treatment to improve oxygen saturation in an acute setting, having high rates of immediate success. 10,[28][29][30] However, medium-to long-term results are not so satisfactory, and there are reports in which almost one-third of the patients did not reach second stage palliation surgery. 10 Arterial duct stenting has been suggested as an alternative to surgery in duct-dependent pulmonary circulation, particularly in high-risk neonates.…”

Section: Discussionmentioning

confidence: 99%

“…5,31 Several technical aspects are important, and results are less satisfactory when the duct has a tortuous morphology or the duct tissue is not completely covered by stents. 14,29 Favourable outcomes recently demonstrated by Genous s stent in adult population of coronary patients, conceptually, open the field for its evaluation in other settings, for example in children. In addition, it is hypothesised that there is a higher proportion of circulating endothelial progenitor cells in young children, which could potentially make the mechanism of stent endothelialisation particularly efficient in this setting.…”

Section: Discussionmentioning

confidence: 99%

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Initial use of endothelial progenitor cells capturing stents in paediatric congenital heart disease

2013

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Introduction: Stenosis, mediated by neointimal hyperplasia and thrombosis, is a major limiting factor in successful stent implantation. The introduction of a stent, coated in its endoluminal surface by antihuman CD34 antibodies with endothelial progenitor cell-capturing properties, opens the possibility of promoting a rapid and normal functioning coverage by endothelium and thus avoids both an excessive cell proliferation within stent and the need for long-term dual antiplatelet therapy. These stents, developed for adult coronary artery disease, have not yet been implanted in children or in those with congenital heart disease. Objective and methods: In this paper, we describe the implantation of Genous s stents in three children with cyanotic congenital heart disease and obstructed systemic-to-pulmonary shunts. We describe the use of this stent and address its potential feasibility in paediatric congenital heart disease. Results: To maintain the patency of two modified Blalock-Taussig shunts and one ductus arteriosus, four Genous s stents were implanted in three infants with cyanotic heart disease. All procedures were immediately successful, with resolution of stenosis and improvement in transcutaneous oxygen saturation from 66% 6 3.6% to 92% 6 2.6%. In the follow-up, one stent had no occlusion; however, the remaining two had partial occlusion after 5 and 5.5 months, which were successfully managed with balloon dilatation preceding elective definitive surgical correction. Conclusion: In our preliminary experience, we demonstrated that Genous s stent implantation was feasible in infants with complex congenital heart disease. Additional studies with larger samples and longer follow-up are required to confirm the potential benefits of this technology in this clinical setting.

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