Use of covered Cheatham-Platinum stents in congenital heart disease.

Abstract

BACKGROUND:

Controversy remains regarding the use of covered stents in congenital heart disease (CHD). We evaluate the possibilities and safety of covered Cheatham-Platinum (CCP) stents in CHD.

METHODS:

Single-center retrospective CHD-database study of all CCP stents, 2003-2012. Three study groups: aortic coarctation (CoA), right ventricular outflow tract pre-stenting for percutaneous revalvulation (RVOT), and miscellaneous. Continuous data expressed as median (range).

RESULTS:

114 CCP stents in 105 patients, age 16.8 years (4.2-71.2). CoA group: 54 CCP stents in 51 patients: 3/54 for aneurysm exclusion, in 51/54 covering used "prophylactically" because of increased risk for vessel tear. Overall, CCP stenting increased the coarctation diameter from 6mm (0-15) to 15 mm (10-20) (p<0.001). RVOT group: 39 CCP stents in 37 patients (34 with RVOT graft, 3 with transannular patch): the graft lumen had shrunken from nominal 21 mm (10-26) to 13 mm (5-22); with the CCP stent the RVOT was redilated to 22 mm (16-26, p<0.001 vs stenosis). Miscellaneous group: 21 CCP stents in 17 patients: closure of Fontan-circuit fenestration (n=5), restoration of superior caval vein (n=2) or pulmonary artery (n=3) patency, relief of supra-pulmonary stenosis (n=2), exclusion of aberrant pulmonary arteries (n=1), cavopulmonary conduit expansion (n=2), Blalock-Taussig shunt flow reduction (n=1), and defibrillator lead protection from sharp stents (n=1). Hybrid procedures performed in 3/17 patients. CCP stent was used as rescue treatment in 2/patients to seal iatrogenic bleeding.

CONCLUSION:

CCP stents can safely be applied in CHD patients. The covering allows adequate sealing of existing or expected tears, thereby increasing the safety margin with more complete dilation.

• Authors: Ward Y Vanagt, Björn Cools, Derize E Boshoff, Stefan Frerich, Ruth Heying, Els Troost, Jacoba Louw, Benedicte Eyskens, Werner Budts, Marc Gewillig
• Journal: International journal of cardiology (Int J Cardiol) Vol. 175 Issue 1 Pg. 102-7 (Jul 15 2014) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 24852832 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Coated Materials, Biocompatible
• Platinum

Topics

• Adolescent
• Adult
• Aged
• Child
• Child, Preschool
• Coated Materials, Biocompatible (administration & dosage)
• Databases, Factual
• Female
• Heart Defects, Congenital (diagnostic imaging, surgery)
• Humans
• Male
• Middle Aged
• Platinum (administration & dosage)
• Radiography
• Retrospective Studies
• Stents (statistics & numerical data)
• Young Adult