PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of brheartjLink to Publisher's site
 
Br Heart J. 1995 December; 74(6): 689–695.
PMCID: PMC484136

Endovascular stents in children under 1 year of age: acute impact and late results.

Abstract

OBJECTIVES--To review efficacy and safety of endovascular stent implants in children < 1 year of age with congenital heart lesions. DESIGN--Retrospective study of patients in a tertiary care setting. PATIENTS--26 children (median age of 4.7 months, range 2 days to 1 year) with various vascular obstructive lesions. INTERVENTION--Percutaneous or intraoperative implantation of balloon expandable endovascular stents. RESULTS--Optimal stent placement was obtained in 31 of the 37 deployed implants. Complications resulted primarily from stent malpositioning and one episode of bleeding at a puncture site. Stent implantation in three patients with a restrictive arterial duct allowed for patency and five patients with conduit stenosis had mean (SD) right ventricule to systemic artery pressure ratios falling from 0.99 (0.20) to 0.52 (0.18) (P < 0.05). In 10 patients with pulmonary artery stenosis, the mean vessel diameter increased from 2.8 (0.9) mm to 5.8 (1.4) mm (P << 0.001). No clinical improvement was seen in two patients because of diffuse hypoplasia of the pulmonary vessels. Nine of 10 patients with miscellaneous obstructive lesions improved clinically. Recatheterisation was performed in 19 patients (median 8 months, range 12 days to 28 months) and 11 patients required redilatation (17 stents). CONCLUSIONS--Stent implantation is technically feasible in infants and under specific circumstances may provide an alternative to surgical palliation or avoid reoperation. The long term impact on clinical course, however, involves further interventions directed at stent management.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.7M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Click on the image to see a larger version.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • O'Laughlin MP, Perry SB, Lock JE, Mullins CE. Use of endovascular stents in congenital heart disease. Circulation. 1991 Jun;83(6):1923–1939. [PubMed]
  • Hosking MC, Benson LN, Nakanishi T, Burrows PE, Williams WG, Freedom RM. Intravascular stent prosthesis for right ventricular outflow obstruction. J Am Coll Cardiol. 1992 Aug;20(2):373–380. [PubMed]
  • Santoian ED, Schneider JE, Gravanis MB, Foegh M, Tarazona N, Cipolla GD, King SB., 3rd Angiopeptin inhibits intimal hyperplasia after angioplasty in porcine coronary arteries. Circulation. 1993 Jul;88(1):11–14. [PubMed]
  • O'Laughlin MP, Slack MC, Grifka RG, Perry SB, Lock JE, Mullins CE. Implantation and intermediate-term follow-up of stents in congenital heart disease. Circulation. 1993 Aug;88(2):605–614. [PubMed]
  • Benson LN, Hamilton F, Dasmahapatra H, Rabinowitch M, Coles JC, Freedom RM. Percutaneous implantation of a balloon-expandable endoprosthesis for pulmonary artery stenosis: an experimental study. J Am Coll Cardiol. 1991 Nov 1;18(5):1303–1308. [PubMed]
  • Rothman A, Perry SB, Keane JF, Lock JE. Early results and follow-up of balloon angioplasty for branch pulmonary artery stenoses. J Am Coll Cardiol. 1990 Apr;15(5):1109–1117. [PubMed]
  • Hosking MC, Thomaidis C, Hamilton R, Burrows PE, Freedom RM, Benson LN. Clinical impact of balloon angioplasty for branch pulmonary arterial stenosis. Am J Cardiol. 1992 Jun 1;69(17):1467–1470. [PubMed]
  • Gibbs JL, Rothman MT, Rees MR, Parsons JM, Blackburn ME, Ruiz CE. Stenting of the arterial duct: a new approach to palliation for pulmonary atresia. Br Heart J. 1992 Mar;67(3):240–245. [PMC free article] [PubMed]
  • Ruiz CE, Gamra H, Zhang HP, García EJ, Boucek MM. Brief report: stenting of the ductus arteriosus as a bridge to cardiac transplantation in infants with the hypoplastic left-heart syndrome. N Engl J Med. 1993 Jun 3;328(22):1605–1608. [PubMed]
  • Rosenthal E, Qureshi SA, Tynan M. Percutaneous pulmonary valvotomy and arterial duct stenting in neonates with right ventricular hypoplasia. Am J Cardiol. 1994 Aug 1;74(3):304–306. [PubMed]
  • McGoon DC, Danielson GK, Puga FJ, Ritter DG, Mair DD, Ilstrup DM. Late results after extracardiac conduit repair for congenital cardiac defects. Am J Cardiol. 1982 May;49(7):1741–1749. [PubMed]
  • Zeevi B, Keane JF, Perry SB, Lock JE. Balloon dilation of postoperative right ventricular outflow obstructions. J Am Coll Cardiol. 1989 Aug;14(2):401–412. [PubMed]
  • Ensing GJ, Hagler DJ, Seward JB, Julsrud PR, Mair DD. Caveats of balloon dilation of conduits and conduit valves. J Am Coll Cardiol. 1989 Aug;14(2):397–400. [PubMed]
  • Morrow WR, Palmaz JC, Tio FO, Ehler WJ, VanDellen AF, Mullins CE. Re-expansion of balloon-expandable stents after growth. J Am Coll Cardiol. 1993 Dec;22(7):2007–2013. [PubMed]

Articles from British Heart Journal are provided here courtesy of BMJ Group