SCAI 2021 Scienfic Sessions Virtual Conference April 28 - May 01, 2021

2021 Catheterization and cardiovascular interventions  
The use of stents in the young often requires follow-up procedures to keep pace with somatic growth in treatment of stenotic vessels, or additional surgical resection with palliative use in stenting the right ventricular outflow tract in tetralogy of Fallot or stenting the ductus arteriosus in ductal dependent lesions. Bioresorbable stents offer the potential for temporary palliation while avoiding some long term complications. Lifetech© Iron-based Bioresorbable Scaffold (IBS ® ) stents have
more » ... n demonstrated to have reliable strength and resorption in animal models. Here we tested these stents for performance during overdilation with assessment of foreshortening, napkinringing, and diameter at time of strut fracture. Methods: Premounted Lifetech© IBS Angel stents (3 stents of each size -4mm by 8, 12, 15, and 38mm; 5mm by 8, 12 and 15mm) were inflated to 2 ATM above rated burst pressure and then post-dilated with 6mm, 7mm, 8mm, and 10mm balloons sequentially until stent fracture with continuous video recording. ImageJ software was used to measure foreshortening and stent diameter with each increase of 1atm until time of fracture. Dilation was continued until complete fracture of all struts with evaluation for napkin-ringing. All bench testing was completed with stents submerged in a water bath heated to a consistent 37 C to mimic in-vivo conditions. Stents were advanced through a 4Fr Prelude sheath prior to dilation and retrieved through sheath post-dilation for qualitative evaluation of fit. Results: First strut fracture for all 4mm stents did not occur until they reached diameters greater than 6mm. First strut fracture for all 6mm stents (premounted on 5mm balloons) did not occur until post-dilated to a diameter of at least 8.9mm. Minimal napkin-ringing of struts was noted with overdilation. All premounted stents passed through 4Fr sheath easily and all balloons were retrieved with minimal resistance after dilation. Conclusions: The 4mm and 6mm Lifetech© IBS Angel stents demonstrated reliable post-dilation to diameters near 50% beyond parameters without fracture and were then found to have complete fracture of all struts without significant napkin-ringing allowing for further expansion if needed prior to bioresorption. Background: Single ventricle patients eligible for Fontan completion routinely undergo pre-Fontan catheterization for complete hemodynamic and anatomic assessment prior to surgery. Cardiac MRI (cMRI) may be used to evaluate pre-Fontan anatomy and collateral burden. We aim to describe our center's outcomes in patients undergoing a pre-Fontan catheterization combined with a cMRI. Methods: A retrospective review of patients undergoing pre-Fontan catheterization from 10/2018 to 10/2020 at Texas Children's Hospital was performed. Patients were divided into 2 groups: combined cMRI and catheterization and those who received catheterization only. Results: Combined cMRI and catheterizations were performed 29 times in 28 patients and 29 catheterizations alone were performed in 29 patients. Both groups were similar in age and weight (Table 1) . Patients undergoing combined procedures have lower fluoroscopy time, contrast dose, in-lab time, and catheterization procedure time. Intubation time and total anesthesia times were higher in the combined procedure group (Table 1) . Patients undergoing a combined procedure were less likely to have a catheter-based intervention performed than in the non-cMRI group. Bypass time, ICU LOS and chest tube duration were similar in the 2 groups (Table 1) . Conclusions: Pre-Fontan assessment including catheterization and cMRI decreases morbidities associated with cardiac catheterization at the expense of longer anesthetic times, and results in similar acute
doi:10.1002/ccd.29644 pmid:33909338 fatcat:m4xin3oqy5evfm7ycvars4t5qu