Covered stents in patients with congenital heart defects.

OBJECTIVES

To evaluate the role of covered Cheatham-Platinum stents in patients with congenital heart disease.

BACKGROUND

There are limited data in the literature about the use of covered stent in patients with congenital heart disease.

METHODS

Between January 2004 and September 2005, covered Cheatham-Platinum stents were implanted into 18 patients with congenital heart defects (9 males, median age 19 years, range 8-45 years). Sixteen had aortic coarctation or recoarctation (8 with associated aneurysm, 1 with patent ductus arteriosus, 3 with an irregular wall, 4 with subatretic native aortic coarctation) (group 1). Two subjects with univentricular heart circulation were treated because of complex right-to-left shunting (Group 2).

RESULTS

Group 1: The stents used ranged from 34 to 45 mm in length. The mean fluoroscopy and procedure times were 12+/-8 and 70+/-15 minutes, respectively. After implantation, the gradient across the stenosis decreased significantly (prestent median value 37 mmHg) (range 20-50 mmHg) versus poststent: median value 0 mmHg (range 0-10 mmHg) (P<0.0001). Vessel diameter increased from a median value of 6 mm (range 0-11) to a median value of 14 mm (range 10-23) (P<0.0001). Stents were placed in the correct position in all subjects. No complications occurred and on angiographic control the stenoses had been relieved and the aneurysms completely excluded. Group 2: Implantation of the covered stents successfully abolished right-to-left shunting in both patients. Both had significant increases in oxygen saturation and no complications occurred.

FOLLOW-UP: During a median follow-up of 7 months (1-19 months), the results were stable without any complications.

CONCLUSION

Covered Cheatham-Platinum stents are very useful tools for treating various congenital cardiovascular malformations.