Abstract
Abstract 13847: Impact of the Unzipping Technique on Pulmonary Artery Structure and Growth
Circulation (New York, N.Y.), Vol.134(Suppl_1 Suppl 1), pp.A13847-A13847
11/11/2016
Abstract
IntroductionWith the unzipping technique, small diameter stents are implanted to relieve pulmonary artery (PA) stenosis, subsequently dilated, fractured and re-stented with large stents dilatable to adult PA diameters. The unzipping technique is utilized in clinical practice with undefined long term results. This study assessed the impact of unzipping on PA structure and growth.MethodsTwelve piglets with left PA (LPA) stenosis underwent the unzipping sequence at 6, 10 and 18 weeks of age and were compared to normal controls and controls with untreated LPA stenosis. 2D and 3D rotational angiography pre/post interventions and PA histology was performed on all animals.ResultsEleven of twelve animals completed the three catheterizations. One stent (4 mm implant diameter) could not be crossed at the second procedure. Following the interventions, the diameter of the unzipped LPA was similar to the proximal LPA of normal controls (14 mm ± 1.2 vs 14.7 mm ± 1, p = 0.19). The diameter of the distal LPA was larger in normal controls, compared to interventions and controls with untreated LPA stenosis (14.6 mm ± 0.9 vs 11.6 mm ± 1.9, vs 10 mm ± 1.2, p < .01). Diameters of six 1 order LPA branches were similar between normal controls and interventions, and larger than the branch diameters in the stenosis controls. Right PA (RPA) dimensions were larger in controls with untreated stenosis, compared to normal controls and interventions (17.8 mm ± 1.2 vs 16.2 mm ± .9 vs 16 ± 1.7 mm p<0.05). RPA 1 order branching diameters were similar for normal controls and interventions. RPA 1 order branch diameters in stenosis controls were larger for 3 of 6 branches compared to normal controls and 1 of 6 compared to interventions. Histologically, the distal LPA displayed uniform fibrointimal proliferation and smooth muscle hypertrophy in pigs with both interventions and untreated stenosis. Focal RPA fibrointimal proliferation was noted in stenosis and intervention animals.ConclusionPA growth distal to the unzipped segment is partially compromised, yet 1 order branch diameters are normal and significantly larger, compared to untreated stenosis. Histological vascular abnormalities are noted bilaterally in stenosis animals which do not normalize following the unzipping technique.
Details
- Title: Subtitle
- Abstract 13847: Impact of the Unzipping Technique on Pulmonary Artery Structure and Growth
- Creators
- Luke Lamers - University of IowaCole NygardRachel LuehrsAlejandro RoldanMelissa Bates
- Resource Type
- Abstract
- Publication Details
- Circulation (New York, N.Y.), Vol.134(Suppl_1 Suppl 1), pp.A13847-A13847
- Publisher
- by the American College of Cardiology Foundation and the American Heart Association, Inc
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Language
- English
- Date published
- 11/11/2016
- Academic Unit
- Stead Family Department of Pediatrics; Fraternal Order of Eagles Diabetes Research Center; Health and Human Physiology; Internal Medicine
- Record Identifier
- 9984288738502771
Metrics
27 Record Views