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

AbstractINTRODUCTION:
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® 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® 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% ± 3.6% to 92% ± 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® 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.
AuthorsNuno Cabanelas, José D F Martins, Fátima Pinto
JournalCardiology in the young (Cardiol Young) Vol. 24 Issue 5 Pg. 900-4 (Oct 2014) ISSN: 1467-1107 [Electronic] England
PMID24044550 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antibodies
  • Antigens, CD34
Topics
  • Antibodies (pharmacology)
  • Antigens, CD34 (immunology)
  • Blalock-Taussig Procedure (instrumentation)
  • Cardiac Catheterization (methods)
  • Drug-Eluting Stents
  • Embolic Protection Devices
  • Endothelial Progenitor Cells (immunology)
  • Feasibility Studies
  • Female
  • Heart Defects, Congenital (surgery)
  • Humans
  • Infant, Newborn
  • Male
  • Prosthesis Design
  • Thrombosis (etiology, prevention & control)
  • Treatment Outcome

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