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The Valeo stent: a pre-mounted, open-cell, large stent for use in small children with CHD

Published online by Cambridge University Press:  23 November 2015

Frances C. Travelli ,
Patrick M. Sullivan ,
Cheryl Takao  and
Frank F. Ing
Frances C. Travelli
Affiliation:
Department of Pediatrics, Keck School of Medicine, Division of Cardiology, Children’s Hospital Los Angeles, University of Southern California, Los Angeles, California, United States of America
Patrick M. Sullivan
Affiliation:
Department of Pediatrics, Keck School of Medicine, Division of Cardiology, Children’s Hospital Los Angeles, University of Southern California, Los Angeles, California, United States of America
Cheryl Takao
Affiliation:
Department of Pediatrics, Keck School of Medicine, Division of Cardiology, Children’s Hospital Los Angeles, University of Southern California, Los Angeles, California, United States of America
Frank F. Ing*
Affiliation:
Department of Pediatrics, Keck School of Medicine, Division of Cardiology, Children’s Hospital Los Angeles, University of Southern California, Los Angeles, California, United States of America
*
Correspondence to: F. F. Ing, MD, Department of Pediatrics, Keck School of Medicine, Division of Cardiology, Children’s Hospital Los Angeles, University of Southern California, 4650 Sunset Boulevard, Mailstop #34, Los Angeles, CA 90027, United States of America. Tel: 323 361 6878; Fax: 323 361 7317; E-mail: fing@chla.usc.edu
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Abstract

Objectives

The aim of the present study was to determine the outcomes of using the Valeo stent (Bard Peripheral Vascular, Tempe, Arizona, United States of America) in small children with CHD.

Background

Stenting vascular stenoses is safe and effective in adults and older children with CHD but is limited in smaller children. The design of the Valeo stent addresses these limitations but has not been extensively described.

Methods

Bench testing was conducted to determine the maximum diameter of the stent, foreshortening, and side-cell diameter. A retrospective analysis of Valeo stents implanted between October, 2012 and October, 2014 was performed. Patient profile, pre-implant/post-implant catheterization data, and stent geometry were reviewed.

Results

Bench testing: medium and large Valeo stents can be dilated up to 13 mm and 20 mm diameters, respectively. Side-cells are dilatable up to 12 mm. Valeo stents are of low profile – delivered through 6- or 7-Fr sheaths – and show minimal foreshortening. Retrospective analysis: a total of 81 stents were implanted in 61 patients with CHD. The median weight was 15.3 kg, and the median age was 58.9 months. Stents were implanted in the pulmonary artery, systemic vein, aorta, and pulmonary vein. Overall, mean vessel diameters increased from 4.1 to 7.7 mm (121.7%). There was effective mean gradient reduction: 3.7–0.5 mmHg (63%) in the venous systems, 28.2–12.5 mmHg (63.7%) in the pulmonary arteries, and 17.4–4 mmHg (77.1%) in the aorta. The mean stent foreshortening was 2.5%, and the mean recoil was 5.9%. Side-cells that crossed other vessels were dilated in four cases, and stents were re-mounted onto different-sized balloons in seven cases.

Conclusions

The features of the Valeo stent, such as low profile, large maximum diameter, open-cell design, minimal foreshortening, and recoil, make it suitable for treating vascular stenoses in small children with CHD.

Keywords

Paediatric intravascular stentingvascular stenosisintervention
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 6 , August 2016 , pp. 1187 - 1193
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Copyright
© Cambridge University Press 2015 

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