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Initial use of endothelial progenitor cells capturing stents in paediatric congenital heart disease

Published online by Cambridge University Press:  18 September 2013

Nuno Cabanelas ,
José D. F. Martins  and
Fátima Pinto
Nuno Cabanelas*
Affiliation:
Department of Cardiology, Santarém Hospital, Santarém, Portugal
José D. F. Martins
Affiliation:
Department of Pediatric Cardiology, Santa Marta Hospital, Central Lisbon Hospital Center, Lisbon, Portugal
Fátima Pinto
Affiliation:
Department of Pediatric Cardiology, Santa Marta Hospital, Central Lisbon Hospital Center, Lisbon, Portugal
*
Correspondence to: N. Cabanelas, Serviço de Cardiologia do Hospital Distrital de Santarém, Avenida Bernardo Santareno, 2000 Santarém, Portugal. Tel: +351 966431810; Fax: +351 243300279; E-mail: ncabanelas@gmail.com
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Abstract

Introduction

Stenosis, mediated by neointimal hyperplasia and thrombosis, is a major limiting factor in successful stent implantation. The introduction of a stent, coated in its endoluminal surface by antihuman CD34 antibodies with endothelial progenitor cell-capturing properties, opens the possibility of promoting a rapid and normal functioning coverage by endothelium and thus avoids both an excessive cell proliferation within stent and the need for long-term dual antiplatelet therapy. These stents, developed for adult coronary artery disease, have not yet been implanted in children or in those with congenital heart disease.

Objective and methods

In this paper, we describe the implantation of Genous® stents in three children with cyanotic congenital heart disease and obstructed systemic-to-pulmonary shunts. We describe the use of this stent and address its potential feasibility in paediatric congenital heart disease.

Results

To maintain the patency of two modified Blalock–Taussig shunts and one ductus arteriosus, four Genous® stents were implanted in three infants with cyanotic heart disease. All procedures were immediately successful, with resolution of stenosis and improvement in transcutaneous oxygen saturation from 66% ± 3.6% to 92% ± 2.6%. In the follow-up, one stent had no occlusion; however, the remaining two had partial occlusion after 5 and 5.5 months, which were successfully managed with balloon dilatation preceding elective definitive surgical correction.

Conclusion

In our preliminary experience, we demonstrated that Genous® stent implantation was feasible in infants with complex congenital heart disease. Additional studies with larger samples and longer follow-up are required to confirm the potential benefits of this technology in this clinical setting.

Keywords

Endothelial progenitor cells capturing stentductus arteriosus stentBlalock–Taussig shunt stenting
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 5 , October 2014 , pp. 900 - 904
Copyright
Copyright © Cambridge University Press 2013 

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