Cardiology in the Young

Original Articles

Large-diameter graft-stent (Advanta V12) implantation in various locations: early results

Dietmar Schranza1 c1, Christian Juxa1, Melanie Vogela1, Jürgen Bauera1, Hakan Akintürka1 and Klaus Valeskea1

a1 Department of Paediatric Cardiology and Cardiac Surgery, Pediatric Heart Center, Justus-Liebig-University Giessen, Germany

Abstract

Objectives Transcatheter stent placement carries the risk of cardiovascular aneurysm or rupture. Covered stent implantation reduces these risks. The recently marketed Advanta V12 large-diameter-covered stent is pre-mounted and requires 9 (8)-11 Fr delivery systems. The aim was to report on the early results of the treatment of various cardiovascular obstructions by the implantation of a new polytetrafluoroethylene-covered stent (V12).

Methods Graft stents on balloons with a diameter (12, 14, 16 millimetres) sufficient to anchor the stent in various obstructions (congenital aortic coarctation, n = 5; obstruction after ascending aorta repair, n = 2; pulmonary arteries, n = 5; inferior caval vein, n = 1; atretic superior caval vein, n = 1; pulmonary vein obstruction, n = 1; and right ventricular outflow tract, n = 1) were implanted using the smallest available delivery system. Secondary dilation with larger-diameter balloons was performed when the residual pressure was gradient, the stent-vessel wall relationship or stent re-coiling due to different reasons needed a re-intervention by pure ballooning or second stent placement.

Results All 16 patients aged 5–46 years underwent V12 implantation. The variability of the treated lesions and the need for additional interventions were responsible for large ranges in fluoroscopy time between 7.3 to 48.2 minutes (median 17.3). Considering the additional procedures, the V12 stent achieved the desired result in all cases. There were no major complications. At short-term median follow-up of 2 months, all patients are alive and well with no evidence of stent failing.

Conclusion These initial results show that the covered Advanta V12 large-diameter stent is safe and effective in the immediate treatment of various cardiovascular obstructions. Long-term follow-up is required.

(Received April 20 2010)

(Accepted September 12 2010)

(Online publication October 27 2010)

Correspondence:

c1 Correspondence to: Professor Dr D. Schranz, Pediatric Heart Center, Justus-Liebig University, Feulgenstrasse 12, 35385 Giessen, Germany. Tel: 049 641 9943461 Fax: 049 641 9943469; E-mail: Dietmar.Schranz@paediat.med.uni-giessen.de