title: First reported use of drug-eluting bioabsorbable vascular scaffold in congenital heart disease.
abstract: The aim of catheter intervention for vascular stenosis is the restoration of lumen area and optimization of distal blood flow. In pediatric practice, this has traditionally been a compromise between less effective balloon angioplasty and bare metal stent insertion with its attendant limitations of size. Bioabsorbable stents offer short-term relief of stenosis, radial support of the healing lesion, return of endothelial function and crucially, in children, the potential for long-term growth. Initial experience, in pediatric practice, with metal-based bioabsorbable stents was relatively disappointing with frequent restenosis secondary to early reabsorption. Design modifications resulting in polymer-based, drug eluting, bioabsorbable vascular scaffolds (BVS) have reportedly overcome some of these faults. We describe the first reported use of a drug eluting BVS in three patients with: (1) A newborn with severe right pulmonary artery (RPA) stensosis post repair of type two common arterial trunk. (2) A child with pulmonary atresia/ventricular septal defect (VSD) and major aorto-pulmonary collateral arteries (MAPCAs), and (3) An infant with severe left pulmonary artery (LPA) stenosis in the setting of an LPA sling.
authors.affiliation: Department of Paediatric Cardiology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
authors.forename: B A
authors.initials: BA
authors.lastname: McCrossan
authors.affiliation: Department of Paediatric Cardiology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
authors.forename: C J
authors.initials: CJ
authors.lastname: McMahon
authors.affiliation: Department of Paediatric Cardiology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
authors.forename: K P
authors.initials: KP
authors.lastname: Walsh
mesh_terms: D020341:Absorbable Implants; D000800:Angioplasty, Balloon / Q000295:instrumentation*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D002648:Child; D020099:Coated Materials, Biocompatible; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019344:Lactic Acid / Q000737:chemistry; D008297:Male; D011091:Polyesters; D011108:Polymers / Q000737:chemistry; D011474:Prosthesis Design; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000503:physiopathology; D012008:Recurrence; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D002317:Cardiovascular Agents; D020099:Coated Materials, Biocompatible; D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)
keywords: bioabsorbable; congenital heart disease; pediatrics; stent; stent restenosis