Covered stents in patients with congenital heart defects

Abstract

Objectives: To evaluate the role of covered Cheatham-Platinum stents in patients with congenital heart disease.

Background: There are limited data in the literature about the use of covered stent in patients with congenital heart disease.

Methods: Between January 2004 and September 2005, covered Cheatham-Platinum stents were implanted into 18 patients with congenital heart defects (9 males, median age 19 years, range 8-45 years). Sixteen had aortic coarctation or recoarctation (8 with associated aneurysm, 1 with patent ductus arteriosus, 3 with an irregular wall, 4 with subatretic native aortic coarctation) (group 1). Two subjects with univentricular heart circulation were treated because of complex right-to-left shunting (Group 2).

Results: Group 1: The stents used ranged from 34 to 45 mm in length. The mean fluoroscopy and procedure times were 12+/-8 and 70+/-15 minutes, respectively. After implantation, the gradient across the stenosis decreased significantly (prestent median value 37 mmHg) (range 20-50 mmHg) versus poststent: median value 0 mmHg (range 0-10 mmHg) (P<0.0001). Vessel diameter increased from a median value of 6 mm (range 0-11) to a median value of 14 mm (range 10-23) (P<0.0001). Stents were placed in the correct position in all subjects. No complications occurred and on angiographic control the stenoses had been relieved and the aneurysms completely excluded. Group 2: Implantation of the covered stents successfully abolished right-to-left shunting in both patients. Both had significant increases in oxygen saturation and no complications occurred.

Follow-up: During a median follow-up of 7 months (1-19 months), the results were stable without any complications.

Conclusion: Covered Cheatham-Platinum stents are very useful tools for treating various congenital cardiovascular malformations.