title: Expandable Valve for Pediatric Application Constructed From Human Venous Valved Conduit Within a Stent.
abstract: OBJECTIVE
  Options for pediatric valve replacement are limited by inability to adapt to child growth. An expandable valve design is presented in which human cryopreserved venous valved conduits are constructed within a bare-metal stent scaffold. We demonstrate functionality in vitro and acute competence in vivo.
  
  
  METHODS
  A cryopreserved femoral venous valved conduit was compressed within a bare-metal stent scaffold and sutured at the proximal and distal ends. In vitro testing was performed at low and high pressure after sequential balloon expansion. Valve morphology was measured in the nondistended state. The construct was tested in 2 patients.
  
  
  RESULTS
  In vitro testing confirmed competence of the 14-mm femoral valve construct at 10-mm to 14-mm diameters. The median leaflet commissural height-to-diameter ratio was 2.2 (range, 1.6 to 4.1) for femoral. The construct was implanted in 2 patients at internal diameters of 6 mm and 8 mm. Echocardiograms demonstrated competence at short-term follow-up. In 1 patient, competence was demonstrated after balloon expansion.
  
  
  CONCLUSIONS
  This study demonstrates the feasibility of this expandable valve design using an allograft venous valved conduit compressed within a stent.
authors.affiliation: Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts; Division of Materials Science and Engineering, Boston University, Boston, Massachusetts.
authors.forename: Erin G
authors.initials: EG
authors.lastname: Roberts
authors.affiliation: Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Luis
authors.initials: L
authors.lastname: Quinonez
authors.affiliation: Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Breanna
authors.initials: B
authors.lastname: Piekarski
authors.affiliation: Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Baird
authors.affiliation: Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts. Electronic address: sitaram.emani@cardio.chboston.org.
authors.forename: Sitaram M
authors.initials: SM
authors.lastname: Emani
mesh_terms: D001705:Bioprosthesis; D004452:Echocardiography; D005260:Female; D005268:Femoral Vein / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000601:surgery*; D007231:Infant, Newborn; D008297:Male; D011474:Prosthesis Design; D011664:Pulmonary Valve / Q000601:surgery*; D015607:Stents; D055422:Venous Valves / Q000637:transplantation*