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The Valeo stent: a pre-mounted, open-cell, large stent for use in small children with CHD
Frances C Travelli1, Patrick M Sullivan1, Cheryl Takao1
1Department of Pediatrics,Keck School of Medicine,Division of Cardiology,Children's Hospital Los Angeles,University of Southern California,Los Angeles,California,United States of America.
Insights
The Valeo stent is safe and effective for treating vascular stenoses in children with congenital heart disease (CHD). This low-profile stent offers a large maximum diameter, making it suitable for pediatric patients.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Vascular Stenting
Background:
- Vascular stenting for congenital heart disease (CHD) is challenging in small children.
- The Valeo stent's design aims to overcome limitations in pediatric patients.
- Limited data exists on the Valeo stent's performance in this population.
Purpose of the Study:
- To evaluate the outcomes of using the Valeo stent in small children with CHD.
- To assess the safety and efficacy of the Valeo stent for vascular stenoses in pediatric CHD.
- To describe the characteristics and performance of the Valeo stent in a pediatric cohort.
Main Methods:
- Bench testing to assess stent diameter, foreshortening, and side-cell size.
- Retrospective analysis of Valeo stents implanted in children with CHD (2012-2014).
- Review of patient demographics, pre/post-catheterization data, and stent geometry.
Main Results:
- Bench tests showed Valeo stents dilate up to 20 mm with minimal foreshortening.
- 81 stents were implanted in 61 pediatric CHD patients (median weight 15.3 kg).
- Significant improvements in vessel diameter and gradient reduction were observed across various vascular beds.
Conclusions:
- The Valeo stent's low profile, large diameter, and minimal recoil make it suitable for pediatric vascular stenoses.
- The stent effectively treated vascular stenoses in small children with CHD.
- The Valeo stent is a promising option for interventional cardiology in pediatric CHD.
Objectives:
The aim of the present study was to determine the outcomes of using the Valeo stent (Bard Peripheral Vascular, Tempe, Arizona, United States of America) in small children with CHD.
Background:
Stenting vascular stenoses is safe and effective in adults and older children with CHD but is limited in smaller children. The design of the Valeo stent addresses these limitations but has not been extensively described.
Methods:
Bench testing was conducted to determine the maximum diameter of the stent, foreshortening, and side-cell diameter. A retrospective analysis of Valeo stents implanted between October, 2012 and October, 2014 was performed. Patient profile, pre-implant/post-implant catheterization data, and stent geometry were reviewed.
Results:
Bench testing: medium and large Valeo stents can be dilated up to 13 mm and 20 mm diameters, respectively. Side-cells are dilatable up to 12 mm. Valeo stents are of low profile - delivered through 6- or 7-Fr sheaths - and show minimal foreshortening. Retrospective analysis: a total of 81 stents were implanted in 61 patients with CHD. The median weight was 15.3 kg, and the median age was 58.9 months. Stents were implanted in the pulmonary artery, systemic vein, aorta, and pulmonary vein. Overall, mean vessel diameters increased from 4.1 to 7.7 mm (121.7%). There was effective mean gradient reduction: 3.7-0.5 mmHg (63%) in the venous systems, 28.2-12.5 mmHg (63.7%) in the pulmonary arteries, and 17.4-4 mmHg (77.1%) in the aorta. The mean stent foreshortening was 2.5%, and the mean recoil was 5.9%. Side-cells that crossed other vessels were dilated in four cases, and stents were re-mounted onto different-sized balloons in seven cases.
Conclusions:
The features of the Valeo stent, such as low profile, large maximum diameter, open-cell design, minimal foreshortening, and recoil, make it suitable for treating vascular stenoses in small children with CHD.
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