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

Abstract

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.

Human cardiac extracellular matrix‑chitosan‑gelatin composite scaffold and its endothelialization

“…Previous studies have shown that seeding of CD34 + cells on grafts enhances endothelialization of the grafts (47). A previous study using a EPC CD34 + capture stent coated with CD34 antibodies used for congenital heart disease surgery demonstrated that the stent could capture EPCs, thereby inhibiting thrombosis by promoting endothelial formation (48). In the present study, human bone marrow-derived CD34 + EPCs were selected and seeded on CG and cECM-CG scaffolds.…”