Acute and long-term effects of endovascular debanding of pulmonary arteries in a swine model

Perez, Michael; Kumar, T.K. Susheel; Hoskoppal, Deepthi; Akkhawattanangkul, Yada; Allen, Kimberly; Knott‐Craig, Christopher J.; Waller, B. Rush; Sathanandam, Shyam

doi:10.1111/chd.12449

Cited by 1 publication

(3 citation statements)

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“…In the PAB group, a left thoracotomy was performed to place a PAB on the proximal left pulmonary artery (LPA) in four newborn piglets (weight: 2.29–2.84 kg). Six weeks post PAB application (weight: 8.1–11.4 kg), endovascular de‐banding using ultra‐high pressure (UHP) balloons was performed as previously described . The piglets were survived for another 6 weeks (weight: 20.4–26 kg).…”

Section: Methodsmentioning

confidence: 99%

“…The technique of PAB placement and de‐banding was previously described in a separate experiment . Via a lateral thoracotomy, a poly‐ethylene terephthalate band was placed around the LPA (Figure A), tightened to achieve a 20–25% reduction in the vessel diameter, and sutured to the adventitia using 6‐0 Prolene.…”

Section: Methodsmentioning

confidence: 99%

“…Six weeks post PAB application (weight: 8.1-11.4 kg), endovascular de-banding using ultra-high pressure (UHP) balloons was performed as previously described. 14 The piglets were survived for another 6 weeks (weight: 20.4-26 kg). A terminal cardiac catheterization was performed to study PA size and residual stenosis in these piglets with balloon angioplasty performed as necessary.…”

Section: Methodsmentioning

confidence: 99%

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Utility of the Medtronic microvascular plug™ as a transcatheter implantable and explantable pulmonary artery flow restrictor in a swine model

Khan

Hoskoppal

Kumar

et al. 2019

Cathet Cardio Intervent

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Background A surgical pulmonary artery band (PAB) is used to control excessive pulmonary blood flow for certain congenital heart diseases. Previous attempts have been made to develop a transcatheter, implantable pulmonary flow restrictor (PFR) without great success. We modified a microvascular plug (MVP) to be used as a PFR. The objectives of this study were to demonstrate feasibility of transcatheter implantation and retrieval of the modified MVP as a PFR, and compare PA growth while using the PFR versus PAB. Methods and results The PFR was implanted in eight newborn piglets in bilateral branch pulmonary arteries (PAs). Immediately post‐PFR implantation, the right ventricular systolic pressure increased from a median of 20–51 mmHg. Transcatheter retrieval of PFR was 100% successful at 3, 6, and 9 weeks and 50% at 12‐weeks post‐implant. A left PAB was placed via thoracotomy in four other newborn piglets. Debanding was performed 6‐weeks later via balloon angioplasty. On follow‐up, the proximal left PA diameters in the PFR and the PAB groups were similar (median 8 vs. 7.1 mm; p = 0.11); albeit the surgical band sites required repeat balloon angioplasty secondary to recurrent stenosis. By histopathology, there was grade II vessel injury in two pigs immediately post‐retrieval of PFR that healed by 12 weeks. Conclusions Transcatheter implantation and retrieval of the MVP as a PFR is feasible. PA growth is comparable to surgical PAB, which is likely to require reinterventions. The use of the MVP as a PFR in humans has to be trialed before recommending its routine use.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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