Pulmonary Artery Growth After Palliation of Congenital Heart Disease With Duct-Dependent Pulmonary Circulation

Santoro, Giuseppe; Capozzi, Giovanbattista; Caianiello, Giuseppe; Palladino, Maria Teresa; Marrone, Chiara; Farina, Gabriella; Russo, Maria Giovanna; Calabrò, Raffaele

doi:10.1016/j.jacc.2009.07.043

Cited by 97 publications

(48 citation statements)

References 31 publications

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“…Early results had reported ductal constriction at sites of exposed ductal tissue after stopping prostaglandin infusion after stent placement [11,12]. More recently, neointimal proliferation within the lumen of the stent has been a common finding [13][14][15][16][17], as was seen in this case. The risks of stent stenosis in a patient with ductal-dependent pulmonary blood flow are significant, and can result in severe cyanosis.…”

Section: Discussionsupporting

confidence: 52%

See 1 more Smart Citation

Persistence of bilateral arterial ducts in pulmonary atresia despite confluent branch pulmonary arteries: Opportunity for two percutaneous therapeautic alternatives

Texter

Shah

Carlson

et al. 2007

Cathet Cardio Intervent

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We present a case of a newborn infant with double inlet left ventricle, pulmonary atresia, confluent pulmonary arteries, and bilateral arterial ducts (AD), to discuss the therapeutic alternatives offered by interventional catheterization techniques in this anatomic arrangement. The infant initially underwent stenting of the right AD to stabilize pulmonary blood flow off of prostaglandin infusion. Three weeks later, she developed left pulmonary artery isolation upon closure of the left arterial duct. An additional stent was placed in the pulmonary artery confluence, restoring blood flow to the left lung and significantly improving her oxygen saturations. At 6 months of age she underwent her first surgical procedure, a successful bidirectional cavopulmonary anastomosis with removal of the left pulmonary artery stent and patch enlargement of the pulmonary artery confluence. She continues to do well in clinical follow-up at 16 months of age.

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Section: Discussionsupporting

confidence: 52%

“…Improved results have been attributed to advances in technique, catheter delivery systems, and stent technology [13][14][15][16][17]. In our patient, patency of the right AD was maintained by stent implantation as an alternative to the surgical creation of an aortopulmonary artery shunt.…”

Section: Discussionmentioning

confidence: 82%

Persistence of bilateral arterial ducts in pulmonary atresia despite confluent branch pulmonary arteries: Opportunity for two percutaneous therapeautic alternatives

Texter

Shah

Carlson

et al. 2007

Cathet Cardio Intervent

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show abstract

“…The load generated from the blood flow has little to no effect on the stent structure. The highest percentage was 10 cases take a number of years to occur. It involves a lot cyclic loading due to the arterial wall contraction as a result of heartbeat.…”

Section: B Failure Analysismentioning

confidence: 99%

“…PDA stenting has shown the effective treatment as it performed in modified Blalock-Taussig (mBT) in promoting global pulmonary artery growth as well as control the distribution of blood flow to pulmonary artery [10]. Nevertheless, keeping the ductal patency via wire mesh called stent until the time of definitive repair was remained challenging for long term survival [13] even though the advance technique on coronary intervention for adult has been implementing [1,[11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Finite element analysis for stent in patent ductus arteriosus (PDA)

Taib

Hao

Shafii

et al. 2015

2015 2nd International Conference on Biomedical Engineering (ICoBE)

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Patent ductus arteriosus (PDA) complication can pose several problems to neonates. Practices that use commonly available stents for neonates have been shown to generate others problems such as re-stenosis and thrombosis formation. Thus, there is a need to introduce a specialized stent for PDA application. In this study, initial effort to design a PDA stent has been started. Investigations were focused on the effect of flow dynamics to the failure of the stent inserted into the PDA. Load effects on stent were modeled using finite element modeling software. Unsteady flow effects including both systolic and diastolic conditions were used to mimic physiological conditions. Stress distributions on the stents struts are analyzed to determine critical area of high stress. Several types of stent including slotted stents and diamond shape stent were used for comparisons. The materials of stents are stainless steels 316L and CobaltChromium L605. The results show that blood flow only contributes to 10 -15 percent of the total stress required for the stent to fail. Distribution of the stresses was found to be highest in the area of joints of the struts for all types studied. The ratio of the maximum stress experienced by the struts to the minimum was roughly double. Comparing all the stresses experienced by the stents, the slotted stent was found to the most susceptible to least favorable.Index Terms -stent, computational fluid dynamics, patent ductus arteriosus (PDA), biomechanics, and medical device

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“…Santoro and colleagues 4 have demonstrated that stenting the patent ductus arteriosus (PDA) is as effective as the mBT shunt in promoting a global pulmonary artery growth and, in addition, ensures an even distribution of pulmonary blood flow. However, keeping the ductus arteriosus reliably patent until the time of definitive repair, generally at 6 to 12 months of age for conduit surgery or first-stage cavopulmonary anastomosis, has remained a challenge until recently.…”

Section: Introductionmentioning

confidence: 99%

Stenting of Lesions in Patent Ductus Arteriosus with Duct-Dependent Pulmonary Blood Flow

Alwi

Mood

2013

Interventional Cardiology Clinics

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Pulmonary Artery Growth After Palliation of Congenital Heart Disease With Duct-Dependent Pulmonary Circulation

Abstract: Percutaneous AD stenting is as effective as MBTS in promoting a global PA growth in CHD-DPC. In addition, it ensures an even distribution of the pulmonary blood flow, thereby promoting a more balanced pulmonary vascular development than MBTS.

Cited by 97 publications

References 31 publications

Persistence of bilateral arterial ducts in pulmonary atresia despite confluent branch pulmonary arteries: Opportunity for two percutaneous therapeautic alternatives

Persistence of bilateral arterial ducts in pulmonary atresia despite confluent branch pulmonary arteries: Opportunity for two percutaneous therapeautic alternatives

Finite element analysis for stent in patent ductus arteriosus (PDA)

Stenting of Lesions in Patent Ductus Arteriosus with Duct-Dependent Pulmonary Blood Flow

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