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Customized covered stent graft for percutaneous closure of Fontan baffle leak

机译:定制的覆膜支架移植物用于经皮封闭Fontan挡板渗漏

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摘要

We report the innovation of both a partly-covered and completely-covered, variable-diameter, balloon-expandable stent that was custom-designed by NuMed, Inc for percutaneous closure of a baffle leak after total caval pulmonary connection (TCPC). A 50-year-old patient, born with tricuspid atresia, who had undergone TCPC, developed severe persistent cyanosis due to a right-to-left shunt through a TCPC baffle leak. Re-operation was deemed too high risk. Therefore, considering his complex anatomy, a custom-made, partly-covered, tapered, balloon-expandable stent was designed and successfully deployed. Months later, the shunt recurred at the junction of the covered to uncovered stent cells; subsequently, a second fully-covered, custom-made, tapered stent was implanted with an excellent outcome. The use of covered or partly-covered customized variable-diameter stents for closure of baffle leak after TCPC is feasible and resulted in marked clinical improvement. Customized balloon-expandable stents may be superior to traditional cylindrical stents because of better anchoring and apposition.
机译:我们报告了由NuMed,Inc定制设计的部分覆盖和完全覆盖的可变直径,球囊扩张式支架的创新,该支架用于在全腔肺连接(TCPC)后经皮封闭挡板漏气。一名患有三尖瓣闭锁症的50岁患者,曾接受TCPC治疗,由于通过TCPC挡板渗漏从右向左分流而出现严重的持续性紫。重新手术被认为风险过高。因此,考虑到他的复杂解剖结构,设计并成功部署了定制的,部分覆盖的,锥形,球囊扩张式支架。几个月后,分流再次发生在覆盖的和未覆盖的支架细胞的交界处。随后,植入了第二个完全覆盖的定制锥形支架,效果极佳。在TCPC之后使用覆盖的或部分覆盖的定制可变直径支架封闭挡板渗漏是可行的,并导致了明显的临床改善。定制的球囊扩张式支架可能会更好地锚固和并置,从而优于传统的圆柱形支架。

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