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Redilation of e-PTFE covered CP stents.
Gianfranco Butera1, Gianpiero Gaio, Mario Carminati
1Department of Pediatric Cardiology, GUCH unit and Cardiac Surgery-Policlinico San Donato IRCCS, San Donato Milanese, Italy. gianfra.but@lycos.com
Summary
Covered Cheatham-Platinum stents can be safely redilated in children with aortic coarctation, allowing for adjustments as they grow. This procedure effectively reduces aortic gradients and restores normal blood flow without complications.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Interventional Radiology
Background:
- Limited literature exists on the redilation of expanded polytetrafluoroethylene (ePTFE) covered Cheatham-Platinum (CP) stents.
- Aortic coarctation in growing children presents challenges due to somatic growth and potential increases in aortic gradients.
Purpose of the Study:
- To assess the feasibility and safety of redilating covered CP stents in patients with aortic coarctation.
- To evaluate the effectiveness of redilation in managing increased aortic gradients and hypertension in pediatric patients.
Main Methods:
- Sixty covered CP stents were implanted for aortic coarctation or recoarctation.
- Seven patients underwent repeat hemodynamic studies due to somatic growth and increased aortic gradients.
- Redilation procedures were performed a mean of 20 months post-implantation.
Main Results:
- Redilation significantly reduced the median gradient across the stenosis from 35 mm Hg to 5 mm Hg.
- Stent diameter increased by 20-50% post-redilation.
- No complications were reported, and angiographic follow-up confirmed relief of stenoses.
Conclusions:
- Covered Cheatham-Platinum stents are amenable to redilation.
- Redilation is a safe and effective option for managing aortic coarctation in growing children.
