Document Detail


Off-label use of stretchable polytetrafluoroethylene: overexpansion of synthetic shunts.
MedLine Citation:
PMID:  20593347     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To describe our experience with balloon dilatation and stenting of modified systemic-to-pulmonary artery (PA) shunts in relation to an assessment and interpretation of the mechanical properties of thin-walled expandable polytetrafluoroethylene (ePTFE) stretch vascular grafts. METHODS: Our pediatric cardiology/cardiac surgery database was reviewed to identify all infants and children with a modified systemic-to-PA shunt who underwent cardiac catheterization. Reports and images were reviewed. Thin-walled stretchable and regular Gore-Tex vascular grafts were mechanically compared using tensiometry. RESULTS: 11 patients underwent dilatation or stenting procedures of a systemic-to-PA shunt. No major complications occurred and none of our patients died during or due to this intervention. High pressures in balloons and stents with diameters larger than the graft were used. Shunt diameters and oxygen saturation levels increased from 2.05 +/- 1.25 mm to 4.75 +/- 0.88 mm and with 12 +/- 6.8%, respectively. In 6 patients re-catheterizations were performed. Four patients died, all with patent shunts. The fail-stress and the fail-strain in the circumferential direction of the stretchable graft were significantly higher than in the non-stretchable graft. CONCLUSIONS: Dilatation and stenting of stenosed modified systemic-to-PA shunts is feasible and safe. Dilatation and stenting of these shunts to calibers larger than those provided by the manufacturer is possible. Results of our technical study posit a great advantage for the use of the thin-walled stretch configuration of ePTFE.
Authors:
Tom O Verbelen; Nele Famaey; Marc Gewillig; Filip R Rega; Bart Meyns
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The International journal of artificial organs     Volume:  33     ISSN:  0391-3988     ISO Abbreviation:  Int J Artif Organs     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-07-02     Completed Date:  2010-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802649     Medline TA:  Int J Artif Organs     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  263-70     Citation Subset:  IM    
Affiliation:
Department of Surgery, University Hospital Gasthuisberg, Leuven, Belgium. tom.verbelen@student.kuleuven.be
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MeSH Terms
Descriptor/Qualifier:
Balloon Dilatation / adverse effects,  instrumentation*,  mortality
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation*,  mortality
Child, Preschool
Constriction, Pathologic
Coronary Angiography
Device Approval
Elastic Modulus
Female
Graft Occlusion, Vascular / etiology,  mortality,  physiopathology,  radiography,  therapy*
Heart Defects, Congenital / mortality,  physiopathology,  surgery*
Humans
Infant
Infant, Newborn
Male
Polytetrafluoroethylene*
Pressure
Prosthesis Design
Pulmonary Artery / physiopathology,  radiography,  surgery*
Retrospective Studies
Stents*
Time Factors
Treatment Outcome
Vascular Patency
Chemical
Reg. No./Substance:
9002-84-0/Polytetrafluoroethylene

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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