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Catheter Cardiovasc Interv. 2019 Apr 19. doi: 10.1002/ccd.28300. [Epub ahead of print]

First use and limitations of Magmaris® bioresorbable stenting in a low birth weight infant with native aortic coarctation.

Author information

1
Department of Pediatric Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
2
Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin (DHZB), Berlin, Germany.
3
Deutsches Zentrum für Herz- und Kreislaufforschung, Partnersite Berlin (DZHK), Berlin, Germany.
4
Department of Congenital Heart Surgery, Deutsches Herzzentrum Berlin (DHZB), Berlin, Germany.

Abstract

We, herein, report the first use of a Magmaris® magnesium-based vascular scaffold for native aortic coarctation in a 1,980 g infant with multiple malformations. Due to the low body weight, complex illness, and clinical instability, it was decided to delay surgical correction. After insufficient results had been obtained by balloon angioplasty, Magmaris® implantation was chosen to bridge the patient to surgery by stabilizing left ventricular function and to allow for sufficient growth. Due to significant early stent restenosis and complete loss of radial force, the patient required balloon reangioplasty only 21 days after Magmaris® implantation and early surgical correction. In addition, high systemic sirolimus levels were detected 48 hr after the intervention (5 ng/mL). Although the bioresorbable scaffold was successfully used as a short-term bridge-to-surgery in our case, due to significant early stent failure (loss of radial force), this approach does not seem promising for long-term bridging of infants with aortic coarctation. In addition, the consequences of sirolimus-induced systemic immunosuppression may further limit the applicability of Magmaris® scaffolds in infants with congenital heart disease.

KEYWORDS:

catheter; critical coarctation; magnesium-based scaffold; radial force; stent

PMID:
31001884
DOI:
10.1002/ccd.28300

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