Stent fractures in congenital heart disease

John P. Breinholt, Alan W. Nugent, Mark A. Law, Henri Justino, Charles E. Mullins, Frank F. Ing

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Objective: To describe incidence, characteristics, predictive factors, and sequelae of stent fractures in congenital heart disease. Background: Stent fracture in congenital heart disease patients is rarely reported. Methods: Patients with stents implanted from 1990 to 2006, with subsequent fluoroscopy were enrolled. Information obtained included: stent type, location, balloon diameter, and residual narrowing. Fracture characteristics, radiographic appearance, and clinical sequelae were also obtained in those with fractures identified. Results: Two hundred and sixty-five patients (583 stents) had fluoroscopy 4.2 ± 3.3 years after stent implantation. The majority of stents (395, 67.7%) were placed in a pulmonary artery (PA) or its branches. Sixteen stents (2.7%) were placed in a right ventricle to pulmonary artery (RV-PA) conduit. Fourteen fractures (2.4%) were identi.ed 5.0 ± 3.2 years after implantation: RV-PA conduit 4/16, proximal right PA 4/135, proximal left PA 6/184 (P = 0.003). Identification was primarily made on lateral fluoroscopy. Review of chest radiographs demonstrated fractures in only 71%. In fractured PA stents, five were redilated and three had additional stents placed. Of the four conduit stent fractures: one underwent redilation, one had embolized segments, and one was reinforced with a second stent that also fractured and embolized a segment during redilation at a later catheterization. All fractures were asymptomatic. Conclusions: With the exception of RV-PA conduit stents, fracture is rare and asymptomatic. PA stent fractures occurred in 2.5% and did not embolize, whereas RV-PA conduit stent fractures were significantly more common and may embolize.

Original languageEnglish (US)
Pages (from-to)977-982
Number of pages6
JournalCatheterization and Cardiovascular Interventions
Volume72
Issue number7
DOIs
StatePublished - Dec 1 2008

Keywords

  • Congenital heart disease
  • Endovascular stents
  • Interventional cardiology
  • Pediatric cardiology
  • Stent complications

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Breinholt, J. P., Nugent, A. W., Law, M. A., Justino, H., Mullins, C. E., & Ing, F. F. (2008). Stent fractures in congenital heart disease. Catheterization and Cardiovascular Interventions, 72(7), 977-982. https://doi.org/10.1002/ccd.21742