The original Palmaz balloon expandable
stent has been used extensively for the treatment of vascular
stenoses in older children and young adults. Placement of the Palmaz
stent in infants and small children, however, is limited by
stent inflexibility, large delivery sheath size, and concerns about creating fixed obstructions after the placement of small diameter
stents in growing patients. New Palmaz Corinthian
stents were placed through 6 French sheaths in four high-risk patients with postoperative
right ventricular outflow obstruction. Patients were not considered candidates for surgical repair. Median patient age and weight were 17 months (range 5-32 months) and 7.7 kg (range 4.6-11.1 kg), respectively. Median fluoroscopy time was 58.2 min (range 55.2-172 min). No complications were encountered. In each case, successful
stent placement was achieved, and surgery with
cardiopulmonary bypass was avoided. Palmaz Corinthian
stents are more flexible, require a smaller delivery sheath, have equal or increased radial strength, and can be maximally expanded to a greater cross sectional area when compared to the original Palmaz
stent. These characteristics make the Palmaz Corinthian
stent a reasonable alternative for use in a select group of infants and small children who are not candidates for surgical repair of postoperative
right ventricular outflow obstruction.