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Using the Valeo dilatable stent in coarctation stenting for small children: expanding the inclusion criteria for
Emma Shepherd1, Georgia May Connolly, Gareth Morgan
1Department of Medicine, University of Bristol, Bristol, UK.
Insights
This study reports the first use of a specific re-dilatable stent for treating aortic coarctation in a child. The Valeo Biliary stent offers a new option for pediatric interventional cardiology.
Area of Science:
- Interventional Cardiology
- Pediatric Cardiovascular Medicine
- Medical Device Technology
Background:
- Coarctation stenting is increasingly used in pediatric and adult patients.
- Technical limitations exist for implanting small-caliber stents in children via small sheaths.
- Stents implanted in children need to accommodate growth to adult size.
Observation:
- The Valeo Biliary Pre-mounted Re-dilatable Stent was used in a 3-year-old girl with severe aortic coarctation and hypertension.
- The stent was successfully implanted through a 7-French sheath.
- One-year follow-up included cross-sectional imaging.
Findings:
- The Valeo Biliary stent was successfully used for aortic coarctation in a pediatric patient.
- This stent can be post-dilated up to 20 mm, accommodating potential growth.
- The procedure was performed despite the patient's critical condition (intracerebral hemorrhage).
Implications:
- This represents the first reported use of the Valeo Biliary stent in aortic coarctation.
- The stent's ability to be post-dilated offers a promising solution for pediatric coarctation.
- It expands the interventional options for treating complex pediatric cardiovascular conditions.
Abstract:
The application of coarctation stenting has grown in paediatric and adult practice in recent years. Stent and delivery sheath technology has improved; however, we remain technically limited when implanting small calibre stents through small sheaths in small children, which then have the potential to be dilated to adult size as time passes. We describe the first reported use of the Valeo Biliary Pre-mounted Re-dilatable Stent (Edwards Life Sciences, California, USA) in aortic coarctation with 1 year follow-up including cross-sectional imaging. This 14 kg 3-year-old girl presented following an intracerebral haemorrhage secondary to severe systemic hypertension. Despite implantation through a 7-French sheath, this stent can be postdilated up to 20 mm, and therefore provides an important new addition to the interventional armamentarium.
