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Stent characteristics for preservation of patency of the arterial duct—experimental evaluation

Published online by Cambridge University Press:  19 August 2008

Eric Rosenthal ,
Shakeel A. Qureshi ,
A. Hussein Tabatabaie ,
Deo Persaud ,
Ashok P. Kakadekar ,
Edward J. Baker  and
Michael Tynan
Eric Rosenthal
Affiliation:
From the Department ofPaediatric Cardiology, Guy’s Hospital, London
Shakeel A. Qureshi*
Affiliation:
From the Department ofPaediatric Cardiology, Guy’s Hospital, London
A. Hussein Tabatabaie
Affiliation:
From the Department ofPaediatric Cardiology, Guy’s Hospital, London
Deo Persaud
Affiliation:
From the Department ofPaediatric Cardiology, Guy’s Hospital, London
Ashok P. Kakadekar
Affiliation:
From the Department ofPaediatric Cardiology, Guy’s Hospital, London
Edward J. Baker
Affiliation:
From the Department ofPaediatric Cardiology, Guy’s Hospital, London
Michael Tynan
Affiliation:
From the Department ofPaediatric Cardiology, Guy’s Hospital, London
*
Dr S. A. Qureshi, Department of Paediatric Cardiology, Guy’s Hospital, St. Thomas St., London SE1 9RT, United Kingdom. Tel. 071-955-4616; Fax. 071-955-4614.
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Summary

In neonates with duct-dependent congenital heart defects, a reliable non-pharmacological, non-surgical method of maintaining flow through the arterial duct may simplify the management. Stent implantation into the arterial duct has been proposed as such a method. In order to evaluate the technical difficulties which may accompany clinical application, stent implantation into the arterial duct was attempted in 32 newborn lambs aged two to nine days (mean 4.2±1.4) weighing 2.4–7.3 kg (mean 4.6±1.0). Four different types of stent were implanted and the ease of implantation and outcomes were assessed. Stent implantation was technically successful in 28 of the 32 lambs (88%). Of these, 11 lambs died shortly after stent implantation with patent ducts, five lambs had early occlusion of the duct and 12 lambs were entered into a long-term study. The Gianturco-Roubin stent was too rigid and too long to enable successful implantation. The Palmaz-Schatz stent was poorly radio-opaque and was difficult to place accurately. When the aortic orifice was not completely covered, the duct occluded within a few days of implantation. The articulation gap also allowed duct tissue to prolapse into the middle of the stent. The Medinvent and Tower stents were simpler to position due to their superior radio-opacity. The Tower stent had an additional advantage in being a single strand stent which could be easily retrieved if misplaced.

Keywords

Stent implantationarterial duct
Type
Original Manuscripts
Information
Cardiology in the Young , Volume 5 , Issue 4 , October 1995 , pp. 331 - 337
Copyright
Copyright © Cambridge University Press 1995

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References

1. Elliot, RB, Starling, MB, Neutze, JM. Medical manipulation of the ductus arteriosus. Lancet 1975; i: 140–142.Google Scholar
2. Rudolph, AM, Heyman, MA, Fishman, N, Lakier, JB. Formalin infiltration of the ductus arteriosus; A method for palliation of infants with selected congenital cardiac lesions. N Engl J Med 1975; 292: 1263–1268.Google Scholar
3. Rosenthal, E, Qureshi, SA, Kakadekar, AP, Anjos, R, Baker, EJ, Tynan, M. Technique of percutaneous laser-assisted valve dilation for valvar atresia in congenital heart disease. Br Heart J 1993; 69: 556–562.CrossRefGoogle ScholarPubMed
4. Radtke, W, Anderson, RR, Guerrero, L, Heintzen, PH. Creation of a palliative shunt by thermal balloon angioplasty of the ductus arteriosus. Proceedings ofXXVI Annual General Meet ing of the Association of European Paediatric Cardiologists,Oslo,June 1990, p 38. [Abstract]Google Scholar
5. Moore, JW, Kirby, WC, Lovett, EJ, O’Neill, JT. Use of an intravascular prosthesis (stent) to establish and maintain short-term patency of the ductus arteriosus in newborn lambs. Cardiovasc Intervent Radiol 1991; 14: 299–301.Google Scholar
6. Coe, JY, Olley, PM. A novel method to maintain ductus arteriosus patency. J Am Coll Cardiol 1991; 18: 837–841.CrossRefGoogle ScholarPubMed
7. Rosenthal, E, Qureshi, SA, Kakadekar, AP, Persaud, D, Tabatabaie, AH, Baker, EJ, Tynan, M. Comparison of balloon dilation and stent implantation to maintain patency of the neonatal arterial duct in lambs. Am J of Cardiol 1993; 71: 1373–1376.Google Scholar
8. Gibbs, JL, Rothman, MT, Rees, MR, Parsons, JM, Blackburn, ME, Ruiz, CE. Stenting the arterial duct: a new approach to palliation for pulmonary atresia. Br Heart J 1991; 65: 256–258.Google Scholar
9. Ruiz, CE, Habib, G, Zhang, HP, Garcia, EJ, Boucek, MM. Stenting of the ductus arteriosus as a bridge to cardiac trans plantation in infants with the hypoplastic heart syndrome. N Engl J Med 1993; 328: 16O5–1608.Google Scholar