Stent expansion of stretch Gore-Tex grafts in children with congenital heart lesions.
OBJECTIVE
To evaluate the efficacy and safety of expanding vascular shunt grafts beyond original nominal diameter using stents.


METHODS
Bench testing confirmed the expandability of 3.5 mm and 4.0 mm vascular Gore-Tex stretch grafts. A retrospective analysis included eleven systemic to pulmonary artery shunts with diminished flow which were stented with the aim of increasing the original nominal diameter of the shunts.


RESULTS
During bench testing, the grafts could be expanded to 4.5 mm and 5.8 mm, respectively. Fourteen stents were implanted in 11 stretch grafts a median of 18.9 months (3.2; 21.6 months) after shunt surgery. There was a median increase in diameter of 1.4 mm (0.9; 1.7 mm) [P = 0.001, 95% CI: 0.47; 1.7) from original nominal to final stented diameter of the shunts with a median gain of 28%. A simultaneous improvement in saturations from a median of 73% (66; 77%) to 87% (84; 89%) [P = 0.015; 95% CI: 3; 22] was observed. No complications were experienced during the procedures.


CONCLUSIONS
In our limited experience, stretch Gore-Tex vascular grafts can be safely expanded beyond nominal diameters using high pressure vascular stents. This leads to improvement in saturation and pulmonary blood flow. It allows the clinician to tailor pulmonary flow in relation to pulmonary artery size and growth, ensuring best possible timing for the next surgical procedure.
Department of Paediatric Cardiology, University of the Free State, Bloemfontein, South Africa.
Stephen C
SC
Brown
Derize E
DE
Boshoff
Ruth
R
Heying
Matthias
M
Gorenflo
Filip
F
Rega
Benedicte
B
Eyskens
Bart
B
Meyns
Marc
M
Gewillig
D000714:Anastomosis, Surgical; D001807:Blood Vessel Prosthesis; D002404:Catheterization; D002675:Child, Preschool; D004548:Elasticity; D005260:Female; D006330:Heart Defects, Congenital / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D011651:Pulmonary Artery / Q000503:physiopathology / Q000601:surgery*; D012039:Regional Blood Flow; D015607:Stents
D011138:Polytetrafluoroethylene