Successful placement and re-expansion of a new balloon expandable stent to maintain patency of the ductus arteriosus in a newborn animal model.
OBJECTIVE
We performed this study in order to evaluate the usefulness of a new balloon expandable stent for maintaining ductal patency in a neonatal piglet model and to evaluate the ability to re-expand the stent weeks following initial implantation.


BACKGROUND
Maintaining patency of the ductus arteriosus without administration of Prostaglandin E has been reported previously using balloon dilation and stent implantation techniques.  However, the experience is limited and the currently available stents are not modified for neonates.


METHODS
14 newborn piglets all at age 12 days and median weight 3.6 Kg (range 2.7-4.3 Kg), underwent initial balloon dilation of the ductus arteriosus.  Angiography after dilation demonstrated no significant left to right shunt.  All piglets underwent successful stent (3.5 mm x 17 mm) placement in the ductus arteriosus.


RESULTS
Percutaneous ductal stent implantation via the arterial route was successful in all piglets with angiographic demonstration of a significant left to right shunt.  Follow-up studies at weekly intervals with color flow Doppler were used to confirm patency of the stents.  In 3 piglets the stent was not patent at initial follow-up and autopsy revealed sub-optimal stent placement.  In two animals the stent was later re-expanded to 4 mm at 22 days, in one to 4 mm at 30 days and in one to 6 mm at 15 days, maintaining flow for an additional period of 15 to 34 days.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Pediatrics, Tufts University School of Medicine, Boston, Massachusetts.
Z M
ZM
Hijazi
M J
MJ
Aronovitz
G R
GR
Marx
D R
DR
Fulton
D000818:Animals; D000831:Animals, Newborn; D004374:Ductus Arteriosus, Patent / Q000601:surgery*; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D006801:Humans; D015607:Stents / Q000009:adverse effects; D013552:Swine