Stent redilation in canine models of congenital heart disease: pulmonary artery stenosis and coarctation of the aorta.
In a canine puppy model, pulmonary artery stenosis was created by banding the left pulmonary artery to 30-40% of its original diameter. Animals underwent right heart catheterization and angiography 1-2 mo later, and Palmaz P308 stents were implanted. Stent redilation was performed 3-5 mo later. One mo postredilation, the animals were restudied and sacrificed. Coarctations of the aorta were created by transverse aortic incision and longitudinal repair. P308 stent implantation was performed 2-3 mo later. Stent redilation was performed after 6-10 mo, and the animals were restudied and sacrificed 1-2 mo later. Stent implantation was performed in 6 puppies with pulmonary artery stenosis, as 2 animals developed postoperative pulmonary arterial hypoplasia, precluding stenting. The stenosis diameter increased from 4.8 +/- 0.5 mm to 7.4 +/- 0.6 mm (mean +/- SE) following stenting (P = 0.005), and increased further to 9.2 +/- 0.7 mm following redilation (P < 0.001). There were no significant vessel tears or ruptures. Coarctation stenting was performed in 8 animals. The coarctation was dilated from 5.8 +/- 0.9 mm to 9.8 +/- 0.6 mm (P < 0.001), and to 13.5 +/- 0.5 mm at redilation (P = 0.002). Redilation could not be performed in 1 animal. Aortic rupture and death occurred in 2 of 7 animals at redilation. Stent implantation and redilation in experimental pulmonary artery stenosis appears safe and effective. Though stent implantation for coarctation of the aorta appears safe, there was a 28% aortic rupture rate at stent redilation in this model.
Mendelsohn
A M
AM
Division of Pediatric Cardiology, C.S. Mott Children's Hospital, University of Michigan Medical Center, Ann Arbor, USA.
Dorostkar
P C
PC
Moorehead
C P
CP
Lupinetti
F M
FM
Reynolds
P I
PI
Ludomirsky
A
A
Lloyd
T R
TR
Heidelberger
K
K
Beekman
R H
RH
D000800:Angioplasty, Balloon; D000818:Animals; D001017:Aortic Coarctation / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D006328:Cardiac Catheterization; D004285:Dogs; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D012008:Recurrence; D015607:Stents