Page 62 - Journal of Structural Heart Disease Volume 2, Issue 6

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Meeting Abstracts
Summary: 3DRA inside the catheterization laboratory is a useful intra-procedural 3D imaging tool, especially during adult congen- ital cardiac interventions. Development of a dedicated “core team” for adult congenital cardiac interventions, dedicated diagnostic/ interventional workup and appropriate training on 3D imaging may reduce time spent on learning curve and allow more e cient use of this new imaging technology.
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NOVEL BIODEGRADABLE STENT FOR TREATMENT OF CONGENITAL HEART DISEASE – 1 YEAR RESULTS IN PORCINE MODEL OF COARCTATION OF AORTA. Surendranath R Veeram Reddy, Tre Welch, Jian Wang, Matthew Riegel, James Richardson, Mohammad Hussain, Gerald Griel, Joseph Forbess, Alan Nugent
UT Southwestern Medical Center, Dallas, Texas, USA
Background: A novel design biodegradable stent (BDS) made of poly- l-lactic-acid has been fabricated up to 12 mm diameter sizes to treat coarctation of aorta (CoA).
Objectives: 1. To create CoA in minipigs. 2. Evaluate feasibility of stent implantation to treat CoA and 3. To assess results at 1 year after stent implantation.
Methods: Thirteen new-born Yucatan minipigs (3-8 kgs) underwent sur- gical CoA creation with elliptical aortic wall resection via the left lateral thoracotomy approach. Cardiac MRI was performed to evaluate the CoA following which biodegradable (BD) and metal stents were implanted 6-8 weeks later. CoA stents were evaluated with MRI, angiography, IVUS and histopathology at 3, 6, 9 and 12 months after stent implantation.
Results: All 13 animals survived CoA creation surgery. Angiography, IVUS and MRI showed mild to moderate CoA at baseline. 12/13 animals underwent successful stent dilation of the CoA with BD (7) and metal (5) stents of 10-12 mm diameters via carotid (10) and femoral (2) access.
Figure 1 (#0116).
Residual CoA persisted in 5 animals following high pressure angioplasty (22 ATMS). The remaining 1 animal was followed as control without stent dilation and euthanized after 3 months following sham cath procedure. One planned non-survival animal was euthanized immediately after stent dilation. Two other animals died within the rst 24 hours after stent dilation due to anesthesia and vascular access complications. At 3-, 6-, 9- and 12-months follow up repeat MRI, angiography and IVUS showed good stent apposition with preserved stent integrity of both BD and metal stents. Histopathology showed complete neo-endothelialization of stent material with mild-moderate in ammatory response.
Conclusions: It is feasible to deliver a novel BDS of 10-12 mm diame- ters to treat CoA in porcine model of CoA. The unique design of the BD stents makes it withstand the elastic forces of the aorta in resistant stenotic lesions. Further studies are needed to evaluate long term vessel/stent patency and assess risks associated with stent fragment embolization during the degradation process.
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AMBULATORY PULMONARY ARTERY PRESSURE MONITORING USING AN IMPLANTABLE SENSOR IN PATIENTS WITH CONGENITAL HEART DISEASE Joanne Chisolm1, Elisa Bradley1, Curt Daniels1, Krista Kukovec1, Darren Berman1
1Nationwide Children’s Hospital, Columbus, Ohio, USA
2The Ohio State University, Columbus, Ohio, USA
Background: Implantable ambulatory pulmonary artery pressure (PAP) monitors are used in the management of advanced chronic heart failure (HF) in adult patients (pts) without congenital heart dis- ease (CHD) by providing direct monitoring and remote transmission of PAP. The CardioMEMS® sensor (St. Jude Medical, Minneapolis, MN) is one such device. HF has been described after repair of complex CHD and can be responsible for clinical deterioration and repeated HF-related hospitalizations.
Hijazi, Z
20th Annual PICS/AICS Meeting Abstracts