Stents in Congenital Heart Disease: State of the Art and Future Scenarios

Stents are tubular meshed endoprostheses implanted mini-invasively through a transcatheter intervention to guarantee the patency of body conduits, mainly in cardiovascular applications. In pediatric cardiology, stenting has become an accepted procedure in the treatment of congenital heart disease (C...

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Main Authors: Alma Brambilla, Giancarlo Pennati, Lorenza Petrini, Francesca Berti
Format: Article
Language:English
Published: MDPI AG 2023-08-01
Series:Applied Sciences
Subjects:
Online Access:https://www.mdpi.com/2076-3417/13/17/9692
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author Alma Brambilla
Giancarlo Pennati
Lorenza Petrini
Francesca Berti
author_facet Alma Brambilla
Giancarlo Pennati
Lorenza Petrini
Francesca Berti
author_sort Alma Brambilla
collection DOAJ
description Stents are tubular meshed endoprostheses implanted mini-invasively through a transcatheter intervention to guarantee the patency of body conduits, mainly in cardiovascular applications. In pediatric cardiology, stenting has become an accepted procedure in the treatment of congenital heart disease (CHD) as an alternative to open-heart surgery. CHD refers to a range of defects affecting the heart’s structure and function arising from abnormal development during pregnancy. While during fetal life, the presence of additional shunts allows for the establishment of parallel circulation and survival of gestation, CHD is not compatible with extrauterine life, and medical intervention is required soon after birth. This review aims to discuss the state of the art of stenting in CHD. Despite the severity of these pathologies, investment from the industry remains limited due to the restricted number of cases, and dedicated devices are still missing. As a consequence, commercially available adult stents are commonly exploited on an off-label basis in newborns without any optimization for the specific anatomy and required function. In this review, a classification of the available stents is provided, resuming the manufacturing technologies, materials, and geometrical aspects to obtain the target biomechanical performance. After analyzing the fetal circulation, different forms of CHD amenable to stenting are considered, collecting the stents currently adopted and discussing the clinical outcomes to outline the features of an ideal device.
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spelling doaj.art-a96b8358196f4600864773003efddc842023-11-19T07:50:30ZengMDPI AGApplied Sciences2076-34172023-08-011317969210.3390/app13179692Stents in Congenital Heart Disease: State of the Art and Future ScenariosAlma Brambilla0Giancarlo Pennati1Lorenza Petrini2Francesca Berti3Department of Civil and Environmental Engineering, Politecnico di Milano, 20133 Milan, ItalyDepartment of Chemistry, Materials and Chemical Engineering “G. Natta” (LaBS), Politecnico di Milano, 20133 Milan, ItalyDepartment of Civil and Environmental Engineering, Politecnico di Milano, 20133 Milan, ItalyDepartment of Chemistry, Materials and Chemical Engineering “G. Natta” (LaBS), Politecnico di Milano, 20133 Milan, ItalyStents are tubular meshed endoprostheses implanted mini-invasively through a transcatheter intervention to guarantee the patency of body conduits, mainly in cardiovascular applications. In pediatric cardiology, stenting has become an accepted procedure in the treatment of congenital heart disease (CHD) as an alternative to open-heart surgery. CHD refers to a range of defects affecting the heart’s structure and function arising from abnormal development during pregnancy. While during fetal life, the presence of additional shunts allows for the establishment of parallel circulation and survival of gestation, CHD is not compatible with extrauterine life, and medical intervention is required soon after birth. This review aims to discuss the state of the art of stenting in CHD. Despite the severity of these pathologies, investment from the industry remains limited due to the restricted number of cases, and dedicated devices are still missing. As a consequence, commercially available adult stents are commonly exploited on an off-label basis in newborns without any optimization for the specific anatomy and required function. In this review, a classification of the available stents is provided, resuming the manufacturing technologies, materials, and geometrical aspects to obtain the target biomechanical performance. After analyzing the fetal circulation, different forms of CHD amenable to stenting are considered, collecting the stents currently adopted and discussing the clinical outcomes to outline the features of an ideal device.https://www.mdpi.com/2076-3417/13/17/9692pediatric cardiologynewborn circulationhypoplastic left heart syndromeaortic coarctationpulmonary atresiapulmonary artery stenosis
spellingShingle Alma Brambilla
Giancarlo Pennati
Lorenza Petrini
Francesca Berti
Stents in Congenital Heart Disease: State of the Art and Future Scenarios
Applied Sciences
pediatric cardiology
newborn circulation
hypoplastic left heart syndrome
aortic coarctation
pulmonary atresia
pulmonary artery stenosis
title Stents in Congenital Heart Disease: State of the Art and Future Scenarios
title_full Stents in Congenital Heart Disease: State of the Art and Future Scenarios
title_fullStr Stents in Congenital Heart Disease: State of the Art and Future Scenarios
title_full_unstemmed Stents in Congenital Heart Disease: State of the Art and Future Scenarios
title_short Stents in Congenital Heart Disease: State of the Art and Future Scenarios
title_sort stents in congenital heart disease state of the art and future scenarios
topic pediatric cardiology
newborn circulation
hypoplastic left heart syndrome
aortic coarctation
pulmonary atresia
pulmonary artery stenosis
url https://www.mdpi.com/2076-3417/13/17/9692
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AT lorenzapetrini stentsincongenitalheartdiseasestateoftheartandfuturescenarios
AT francescaberti stentsincongenitalheartdiseasestateoftheartandfuturescenarios