The role of stents in the treatment of congenital heart disease: Current status and future perspectives

Abstract

Intravascular or intracardiac stenoses occur in many forms of congenital heart disease (CHD). Therefore, the implantation of stents has become an accepted interventional procedure for stenotic lesions in pediatric cardiology. Furthermore, stents are know to be used to exclude vessel aneurysm or to ensure patency of existing or newly created intracardiac communications. With the further refinement of the first generation of devices, a variety of “modern” stents with different design characteristics have evolved. Despite the tremendous technical improvement over the last 20 years, the “ideal stent” has not yet been developed. Therefore, the pediatric interventionalist has to decide which stent is suitable for each lesion. On this basis, currently available stents are discussed in regard to their advantages and disadvantages for common application in CHD. New concepts and designs developed to overcome some of the existing problems, like the failure of adaptation to somatic growth, are presented. Thus, in the future, biodegradable or growth stents might replace the currently used generation of stents. This might truly lead to widening indications for the use of stents in the treatment of CHD.

Stent Fitting using Cylindrical Affine Transformation Model for Pulmonary Artery

“…As described by Dotter and Judkins, this procedure requires the vessel to be held open [2], stent implantation exactly serves that purpose. Stents exert radial force on vessel walls preventing their acute closure thereby improving the blood flow [3]. The main reason for success of stent implantation in pulmonary artery in spite of adverse risk factors involved is same as found out in trails initiated by Serruys et al for coronary artery i.e.…”

Pulmonary valve and right ventricular outflow tract surgery in adults: 23-year experience

“…The history of CHD is often present in these cases, and individual surgical indications depend on patient characteristics [22]. Aneurysms of the PA are often related to right ventricular congenital lesions, and surgery remains the strategy of choice [6].…”

A review of stent’s failure on patent ductus arteriosus

“…Advantage of stent decaying proses poses by degradable stent solved the main concern in pediatric stenting as suitable for baby's growth. The ideal characteristics of a biodegradable stent have been defined as (1) sufficient radial strength to prevent vascular recoil, (2) minimal thrombotic and inflammatory response (3) avoidance of intimal proliferation (4) reabsorption of stent components within months (5) no release of toxic products or embolic material during breakdown and (6) easy processing and sterilization [17].…”