Takanari Fujii - Academia.edu (original) (raw)

Papers by Takanari Fujii

Research paper thumbnail of Transcatheter closure of perimembranous ventricular septal defects with Amplatzer® duct occluder I; The first case report in Japan

Journal of Cardiology Cases, 2019

We report the first case of transcatheter perimembranous ventricular septal defect (pmVSD) closur... more We report the first case of transcatheter perimembranous ventricular septal defect (pmVSD) closure in Japan where none of existing devices for VSD closure has been approved. The pmVSD was successfully closed with first generation Amplatzer® duct occluder (ADO-I; St Jude Medical, St Paul, MN, USA). The procedure was performed under general anesthesia with transesophageal echocardiographic and fluoroscopic guidance. The left ventricular volume overload after the procedure was remarkably improved and no major complications occurred. ADO-I can be a safe and effective option for transcatheter pmVSD closure. The incidence of heart block may be less than reported with the original device. <Learning objective: Use of Amplatzer® duct occluder is effective in transcatheter perimembranous ventricular septal defect (pmVSD) closure in selected patients. It may be safer than original Amplatzer pmVSD occluder to avoid complete atrioventricular block.>.

Research paper thumbnail of Stenting for curved lesions using a novel curved balloon: Preliminary experimental study

Journal of cardiology, Jan 6, 2014

Stenting may be a compelling approach to dilating curved lesions in congenital heart diseases. Ho... more Stenting may be a compelling approach to dilating curved lesions in congenital heart diseases. However, balloon-expandable stents, which are commonly used for congenital heart diseases, are usually deployed in a straight orientation. In this study, we evaluated the effect of stenting with a novel curved balloon considered to provide better conformability to the curved-angled lesion. In vitro experiments: A Palmaz Genesis(®) stent (Johnson & Johnson, Cordis Co, Bridgewater, NJ, USA) mounted on the Goku(®) curve (Tokai Medical Co. Nagoya, Japan) was dilated in vitro to observe directly the behavior of the stent and balloon assembly during expansion. Animal experiment: A short Express(®) Vascular SD (Boston Scientific Co, Marlborough, MA, USA) stent and a long Express(®) Vascular LD stent (Boston Scientific) mounted on the curved balloon were deployed in the curved vessel of a pig to observe the effect of stenting in vivo. In vitro experiments: Although the stent was dilated in a curve...

Research paper thumbnail of Stent Unzipping Using Ultra High Pressure Balloon: In Vitro, and Animal Experiment

Journal of the American College of Cardiology, 2016

As the child grows, the limitation of maximally dilatable stent diameter (MDD) may result in sten... more As the child grows, the limitation of maximally dilatable stent diameter (MDD) may result in stenosis associated with size-mismatch. If an implanted stent can be intentionally fractured along its length called “unzipped”, it may eventually be redilated to the adult vessel diameter. Few studies

Research paper thumbnail of 動脈管開存に対するカテーテル治療におけるコイル閉鎖術の役割：Amplatzer<sup>®</sup> Duct Occluder導入前後で比較

Pediatric Cardiology and Cardiac Surgery, 2014

Research paper thumbnail of An infant with primary pulmonary vein stenosis, associated with fatal occlusion of intraparenchymal small pulmonary veins

Journal of Cardiology Cases, 2014

Primary pulmonary vein stenosis (PVS) is rare within the pediatric population and its pathophysio... more Primary pulmonary vein stenosis (PVS) is rare within the pediatric population and its pathophysiology remains unclear, especially as to how the histopathology relates to its refractoriness to treatment. We report the case of a 4-month-old girl with primary PVS. The lesion in this patient was characterized by fatal obstruction of intraparenchymal small pulmonary veins, associated with localized stenosis at the four pulmonary veno-atrial junctions. All four localized stenoses underwent transcatheter stent implantation. Although the procedure was technically successful, her clinical status failed to improve, and she died 2 months after stenting. Histopathological examination of lung specimens showed severe luminal obstruction by marked intimal proliferation with fibrosis in the intraparenchymal small pulmonary veins, and these findings were present in every lobe. To the best of our knowledge, the histopathological findings and clinical course in this case, including the response to treatments, are extremely rare. We suggest that the histological findings of the small pulmonary veins are important in deciding the indication and appropriate timing of intervention. <Learning objective: The outcome of primary pulmonary vein stenosis has remained poor despite aggressive treatment, while the indication and appropriate timing of intervention has not been clarified. The histological findings of small pulmonary veins are important to predict the response to treatment and outcome, and early intervention might prevent the secondary progression of this disease.>

Research paper thumbnail of Current trends in stenting for aortic coarctation in Japan; subanalysis of Japanese society of pediatric interventional cardiology (JPIC) stent survey

Pediatrics International, 2015

Stenting for aortic coarctation (CoA) has been accepted as an alternative to surgery for adolesce... more Stenting for aortic coarctation (CoA) has been accepted as an alternative to surgery for adolescents and adults. However, only a few patients have been reported in Japan. The purpose of this study is to provide a detailed review of Japanese national data on stenting of CoA. In a subanalysis of the data of the Japanese society of Pediatric Interventional Cardiology (JPIC), we identified 35patients with CoA who underwent stenting. We analyzed procedural characteristics including factors which may have contributed to hemodynamic effectiveness, and we compared these parameters between the patients under and over 15-year-old. The ratio of balloon diameter / minimum lumen diameter (MLD) before stenting was 1.7 (1.2-4.0), and the mean difference between the balloon diameter and the reference vessel diameter (RVD) which is calculated by the RVD subtracted from the balloon diameter ( balloon diameter - RVD) was -0.7 (-5.0 - + 3.0 ) mm. %MLD / balloon diameter, which was defined as [(balloon diameter - MLD after dilation)/ balloon diameter]×100 predicted achievement of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;10 mmHg pressure gradient after stenting. The sensitivity and the specificity of its cut off value of 7% were 93% and 47% (AUC 0.7), respectively. There was no statistical difference between the two age groups under and over 15-year-old, in terms of selection criteria of stent size, balloon type used for deployment and immediate angiographic and hemodynamic result. Stenting for CoA was clinically effective with few complications in Japan, even in patients not fully grown. This article is protected by copyright. All rights reserved.

Research paper thumbnail of Novel Curved Balloon Catheter for Dilating Postoperative Angled Lesions Associated with Congenital Heart Disease

Journal of Interventional Cardiology

This study aimed to analyze the surface stress generated by a novel curved balloon and assess its... more This study aimed to analyze the surface stress generated by a novel curved balloon and assess its efficacy for treating angular lesions associated with congenital heart disease. Obstructions at the anastomosis of aortopulmonary shunts and cavopulmonary connections may occur postoperatively. Catheter interventions are often performed for such lesions; however, acute angulation may cause balloon slippage or inappropriate stress on the vessel wall. We dilated the curved balloon in a curved vessel model and measured the resultant wall stress and its distribution. Clinical evaluations were performed using this balloon in angled lesions. In the curved vessel model, curved balloons generated uniform stress on the lesser and greater curvatures (curved type, lesser/greater = 0.343 MPa/0.327 MPa; P = 0.61), whereas straight balloons caused disproportionate stress (straight type, lesser/greater = 0.358 MPa/0.254 MPa; P = 0.19). However, the difference in average stress was not statistically si...

Research paper thumbnail of Stenting for pulmonary artery stenosis complicated by univentricular physiology: Subanalysis of JPIC stent survey

Journal of Cardiology

Stent implantation is an important treatment option for pulmonary artery stenosis (PS), even if c... more Stent implantation is an important treatment option for pulmonary artery stenosis (PS), even if complicated by univentricular physiology (UVP). However, there is paucity of evidence concerning not only its hemodynamic and morphologic indications but also on markers for its optimal target attainment in UVP. The purpose of this study was to evaluate the acute outcome and factors associated with efficacy of stenting for PS complicating UVP. A subanalysis was performed using the data of the Japanese Society of Pediatric Interventional Cardiology (JPIC) stent survey. We analyzed the morphologic and hemodynamic data of 11 patients with UVP who underwent stenting for PS. We defined "a 50% increase in the minimum lumen diameter (MLD)" as "morphologically effective," and "an achievement of 0mmHg pressure gradient" as "hemodynamically effective." We analyzed the success rate for each criterion and determined factors which may have contributed to hemodyn...

Research paper thumbnail of Successful Emergent Aspiration of Thrombus for Postoperative Superior Vena Cava （SVC）Obstruction Presenting Critical SVC Syndrome in Early Infancy

Research paper thumbnail of Restored left ventricular function following transcatheter closure of a persistent ductus arteriosus in an adult

Journal of Cardiology Cases, 2013

Research paper thumbnail of Novel Curved Balloon Catheter for Dilating Postoperative Angled Lesions Associated with Congenital Heart Disease

Journal of Interventional Cardiology, 2014

This study aimed to analyze the surface stress generated by a novel curved balloon and assess its... more This study aimed to analyze the surface stress generated by a novel curved balloon and assess its efficacy for treating angular lesions associated with congenital heart disease. Obstructions at the anastomosis of aortopulmonary shunts and cavopulmonary connections may occur postoperatively. Catheter interventions are often performed for such lesions; however, acute angulation may cause balloon slippage or inappropriate stress on the vessel wall. We dilated the curved balloon in a curved vessel model and measured the resultant wall stress and its distribution. Clinical evaluations were performed using this balloon in angled lesions. In the curved vessel model, curved balloons generated uniform stress on the lesser and greater curvatures (curved type, lesser/greater = 0.343 MPa/0.327 MPa; P = 0.61), whereas straight balloons caused disproportionate stress (straight type, lesser/greater = 0.358 MPa/0.254 MPa; P = 0.19). However, the difference in average stress was not statistically significant. Furthermore, the stress was uniform along the entire length of the curved balloon, but differed between the mid and end portions of the straight balloon. Curved balloon dilations were performed for 10 lesions in 7 patients. The curved balloon conformed well to the angulated lesion without slipping. The median percent change in the minimal lumen diameter (MLD) was 64% (range, 0-206%). In 5 lesions, MLD increased by ≥50%. Oxygen saturation increased by 5% (0-9%). Although further clinical evaluation is necessary, this novel curved balloon may be a reasonable alternative in angled lesions, providing better conformability and preventing excessive stress to the vessel wall adjacent to the stenosis.

Research paper thumbnail of Stenting for pulmonary artery stenosis complicated by univentricular physiology: Subanalysis of JPIC stent survey

Journal of Cardiology, 2014

Background and purpose: Stent implantation is an important treatment option for pulmonary artery ... more Background and purpose: Stent implantation is an important treatment option for pulmonary artery stenosis (PS), even if complicated by univentricular physiology (UVP). However, there is paucity of evidence concerning not only its hemodynamic and morphologic indications but also on markers for its optimal target attainment in UVP. The purpose of this study was to evaluate the acute outcome and factors associated with efficacy of stenting for PS complicating UVP. Methods and subjects: A subanalysis was performed using the data of the Japanese Society of Pediatric Interventional Cardiology (JPIC) stent survey. We analyzed the morphologic and hemodynamic data of 11 patients with UVP who underwent stenting for PS. We defined "a 50% increase in the minimum lumen diameter (MLD)" as "morphologically effective," and "an achievement of 0 mmHg pressure gradient" as "hemodynamically effective." We analyzed the success rate for each criterion and determined factors which may have contributed to hemodynamic effectiveness. Results: Stenting was morphologically effective in all patients, while it was hemodynamically effective in 6/11 (55%). The percent diameter stenosis after stenting was significantly lower in the "hemodynamically effective" group (2.5 ± 5.5% vs 19.6 ± 13.1%, p = 0.017). The cutoff value of percent diameter stenosis after stenting to "hemodynamically effective" was 14.6%; the sensitivity was 80% and the specificity was 100% (area under the curve 0.825, p = 0.021). Conclusions: The percent diameter stenosis after stenting significantly contributed to achieving a "0 mmHg" pressure gradient, while in order to achieve a "0 mmHg" pressure gradient, the residual percent diameter stenosis should be less than around 15%.

Research paper thumbnail of Stenting for curved lesions using a novel curved balloon: Preliminary experimental study

Journal of cardiology, Jan 6, 2014

Stenting may be a compelling approach to dilating curved lesions in congenital heart diseases. Ho... more Stenting may be a compelling approach to dilating curved lesions in congenital heart diseases. However, balloon-expandable stents, which are commonly used for congenital heart diseases, are usually deployed in a straight orientation. In this study, we evaluated the effect of stenting with a novel curved balloon considered to provide better conformability to the curved-angled lesion. In vitro experiments: A Palmaz Genesis(®) stent (Johnson & Johnson, Cordis Co, Bridgewater, NJ, USA) mounted on the Goku(®) curve (Tokai Medical Co. Nagoya, Japan) was dilated in vitro to observe directly the behavior of the stent and balloon assembly during expansion. Animal experiment: A short Express(®) Vascular SD (Boston Scientific Co, Marlborough, MA, USA) stent and a long Express(®) Vascular LD stent (Boston Scientific) mounted on the curved balloon were deployed in the curved vessel of a pig to observe the effect of stenting in vivo. In vitro experiments: Although the stent was dilated in a curve...

Research paper thumbnail of Transcatheter closure of perimembranous ventricular septal defects with Amplatzer® duct occluder I; The first case report in Japan

Journal of Cardiology Cases, 2019

We report the first case of transcatheter perimembranous ventricular septal defect (pmVSD) closur... more We report the first case of transcatheter perimembranous ventricular septal defect (pmVSD) closure in Japan where none of existing devices for VSD closure has been approved. The pmVSD was successfully closed with first generation Amplatzer® duct occluder (ADO-I; St Jude Medical, St Paul, MN, USA). The procedure was performed under general anesthesia with transesophageal echocardiographic and fluoroscopic guidance. The left ventricular volume overload after the procedure was remarkably improved and no major complications occurred. ADO-I can be a safe and effective option for transcatheter pmVSD closure. The incidence of heart block may be less than reported with the original device. <Learning objective: Use of Amplatzer® duct occluder is effective in transcatheter perimembranous ventricular septal defect (pmVSD) closure in selected patients. It may be safer than original Amplatzer pmVSD occluder to avoid complete atrioventricular block.>.

Research paper thumbnail of Stenting for curved lesions using a novel curved balloon: Preliminary experimental study

Journal of cardiology, Jan 6, 2014

Stenting may be a compelling approach to dilating curved lesions in congenital heart diseases. Ho... more Stenting may be a compelling approach to dilating curved lesions in congenital heart diseases. However, balloon-expandable stents, which are commonly used for congenital heart diseases, are usually deployed in a straight orientation. In this study, we evaluated the effect of stenting with a novel curved balloon considered to provide better conformability to the curved-angled lesion. In vitro experiments: A Palmaz Genesis(®) stent (Johnson & Johnson, Cordis Co, Bridgewater, NJ, USA) mounted on the Goku(®) curve (Tokai Medical Co. Nagoya, Japan) was dilated in vitro to observe directly the behavior of the stent and balloon assembly during expansion. Animal experiment: A short Express(®) Vascular SD (Boston Scientific Co, Marlborough, MA, USA) stent and a long Express(®) Vascular LD stent (Boston Scientific) mounted on the curved balloon were deployed in the curved vessel of a pig to observe the effect of stenting in vivo. In vitro experiments: Although the stent was dilated in a curve...

Research paper thumbnail of Stent Unzipping Using Ultra High Pressure Balloon: In Vitro, and Animal Experiment

Journal of the American College of Cardiology, 2016

As the child grows, the limitation of maximally dilatable stent diameter (MDD) may result in sten... more As the child grows, the limitation of maximally dilatable stent diameter (MDD) may result in stenosis associated with size-mismatch. If an implanted stent can be intentionally fractured along its length called “unzipped”, it may eventually be redilated to the adult vessel diameter. Few studies

Research paper thumbnail of 動脈管開存に対するカテーテル治療におけるコイル閉鎖術の役割：Amplatzer<sup>®</sup> Duct Occluder導入前後で比較

Pediatric Cardiology and Cardiac Surgery, 2014

Research paper thumbnail of An infant with primary pulmonary vein stenosis, associated with fatal occlusion of intraparenchymal small pulmonary veins

Journal of Cardiology Cases, 2014

Primary pulmonary vein stenosis (PVS) is rare within the pediatric population and its pathophysio... more Primary pulmonary vein stenosis (PVS) is rare within the pediatric population and its pathophysiology remains unclear, especially as to how the histopathology relates to its refractoriness to treatment. We report the case of a 4-month-old girl with primary PVS. The lesion in this patient was characterized by fatal obstruction of intraparenchymal small pulmonary veins, associated with localized stenosis at the four pulmonary veno-atrial junctions. All four localized stenoses underwent transcatheter stent implantation. Although the procedure was technically successful, her clinical status failed to improve, and she died 2 months after stenting. Histopathological examination of lung specimens showed severe luminal obstruction by marked intimal proliferation with fibrosis in the intraparenchymal small pulmonary veins, and these findings were present in every lobe. To the best of our knowledge, the histopathological findings and clinical course in this case, including the response to treatments, are extremely rare. We suggest that the histological findings of the small pulmonary veins are important in deciding the indication and appropriate timing of intervention. <Learning objective: The outcome of primary pulmonary vein stenosis has remained poor despite aggressive treatment, while the indication and appropriate timing of intervention has not been clarified. The histological findings of small pulmonary veins are important to predict the response to treatment and outcome, and early intervention might prevent the secondary progression of this disease.>

Research paper thumbnail of Current trends in stenting for aortic coarctation in Japan; subanalysis of Japanese society of pediatric interventional cardiology (JPIC) stent survey

Pediatrics International, 2015

Stenting for aortic coarctation (CoA) has been accepted as an alternative to surgery for adolesce... more Stenting for aortic coarctation (CoA) has been accepted as an alternative to surgery for adolescents and adults. However, only a few patients have been reported in Japan. The purpose of this study is to provide a detailed review of Japanese national data on stenting of CoA. In a subanalysis of the data of the Japanese society of Pediatric Interventional Cardiology (JPIC), we identified 35patients with CoA who underwent stenting. We analyzed procedural characteristics including factors which may have contributed to hemodynamic effectiveness, and we compared these parameters between the patients under and over 15-year-old. The ratio of balloon diameter / minimum lumen diameter (MLD) before stenting was 1.7 (1.2-4.0), and the mean difference between the balloon diameter and the reference vessel diameter (RVD) which is calculated by the RVD subtracted from the balloon diameter ( balloon diameter - RVD) was -0.7 (-5.0 - + 3.0 ) mm. %MLD / balloon diameter, which was defined as [(balloon diameter - MLD after dilation)/ balloon diameter]×100 predicted achievement of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;10 mmHg pressure gradient after stenting. The sensitivity and the specificity of its cut off value of 7% were 93% and 47% (AUC 0.7), respectively. There was no statistical difference between the two age groups under and over 15-year-old, in terms of selection criteria of stent size, balloon type used for deployment and immediate angiographic and hemodynamic result. Stenting for CoA was clinically effective with few complications in Japan, even in patients not fully grown. This article is protected by copyright. All rights reserved.

Research paper thumbnail of Novel Curved Balloon Catheter for Dilating Postoperative Angled Lesions Associated with Congenital Heart Disease

Journal of Interventional Cardiology

This study aimed to analyze the surface stress generated by a novel curved balloon and assess its... more This study aimed to analyze the surface stress generated by a novel curved balloon and assess its efficacy for treating angular lesions associated with congenital heart disease. Obstructions at the anastomosis of aortopulmonary shunts and cavopulmonary connections may occur postoperatively. Catheter interventions are often performed for such lesions; however, acute angulation may cause balloon slippage or inappropriate stress on the vessel wall. We dilated the curved balloon in a curved vessel model and measured the resultant wall stress and its distribution. Clinical evaluations were performed using this balloon in angled lesions. In the curved vessel model, curved balloons generated uniform stress on the lesser and greater curvatures (curved type, lesser/greater = 0.343 MPa/0.327 MPa; P = 0.61), whereas straight balloons caused disproportionate stress (straight type, lesser/greater = 0.358 MPa/0.254 MPa; P = 0.19). However, the difference in average stress was not statistically si...

Research paper thumbnail of Stenting for pulmonary artery stenosis complicated by univentricular physiology: Subanalysis of JPIC stent survey

Journal of Cardiology

Stent implantation is an important treatment option for pulmonary artery stenosis (PS), even if c... more Stent implantation is an important treatment option for pulmonary artery stenosis (PS), even if complicated by univentricular physiology (UVP). However, there is paucity of evidence concerning not only its hemodynamic and morphologic indications but also on markers for its optimal target attainment in UVP. The purpose of this study was to evaluate the acute outcome and factors associated with efficacy of stenting for PS complicating UVP. A subanalysis was performed using the data of the Japanese Society of Pediatric Interventional Cardiology (JPIC) stent survey. We analyzed the morphologic and hemodynamic data of 11 patients with UVP who underwent stenting for PS. We defined "a 50% increase in the minimum lumen diameter (MLD)" as "morphologically effective," and "an achievement of 0mmHg pressure gradient" as "hemodynamically effective." We analyzed the success rate for each criterion and determined factors which may have contributed to hemodyn...

Research paper thumbnail of Successful Emergent Aspiration of Thrombus for Postoperative Superior Vena Cava （SVC）Obstruction Presenting Critical SVC Syndrome in Early Infancy

Research paper thumbnail of Restored left ventricular function following transcatheter closure of a persistent ductus arteriosus in an adult

Journal of Cardiology Cases, 2013

Research paper thumbnail of Novel Curved Balloon Catheter for Dilating Postoperative Angled Lesions Associated with Congenital Heart Disease

Journal of Interventional Cardiology, 2014

This study aimed to analyze the surface stress generated by a novel curved balloon and assess its... more This study aimed to analyze the surface stress generated by a novel curved balloon and assess its efficacy for treating angular lesions associated with congenital heart disease. Obstructions at the anastomosis of aortopulmonary shunts and cavopulmonary connections may occur postoperatively. Catheter interventions are often performed for such lesions; however, acute angulation may cause balloon slippage or inappropriate stress on the vessel wall. We dilated the curved balloon in a curved vessel model and measured the resultant wall stress and its distribution. Clinical evaluations were performed using this balloon in angled lesions. In the curved vessel model, curved balloons generated uniform stress on the lesser and greater curvatures (curved type, lesser/greater = 0.343 MPa/0.327 MPa; P = 0.61), whereas straight balloons caused disproportionate stress (straight type, lesser/greater = 0.358 MPa/0.254 MPa; P = 0.19). However, the difference in average stress was not statistically significant. Furthermore, the stress was uniform along the entire length of the curved balloon, but differed between the mid and end portions of the straight balloon. Curved balloon dilations were performed for 10 lesions in 7 patients. The curved balloon conformed well to the angulated lesion without slipping. The median percent change in the minimal lumen diameter (MLD) was 64% (range, 0-206%). In 5 lesions, MLD increased by ≥50%. Oxygen saturation increased by 5% (0-9%). Although further clinical evaluation is necessary, this novel curved balloon may be a reasonable alternative in angled lesions, providing better conformability and preventing excessive stress to the vessel wall adjacent to the stenosis.

Research paper thumbnail of Stenting for pulmonary artery stenosis complicated by univentricular physiology: Subanalysis of JPIC stent survey

Journal of Cardiology, 2014

Background and purpose: Stent implantation is an important treatment option for pulmonary artery ... more Background and purpose: Stent implantation is an important treatment option for pulmonary artery stenosis (PS), even if complicated by univentricular physiology (UVP). However, there is paucity of evidence concerning not only its hemodynamic and morphologic indications but also on markers for its optimal target attainment in UVP. The purpose of this study was to evaluate the acute outcome and factors associated with efficacy of stenting for PS complicating UVP. Methods and subjects: A subanalysis was performed using the data of the Japanese Society of Pediatric Interventional Cardiology (JPIC) stent survey. We analyzed the morphologic and hemodynamic data of 11 patients with UVP who underwent stenting for PS. We defined "a 50% increase in the minimum lumen diameter (MLD)" as "morphologically effective," and "an achievement of 0 mmHg pressure gradient" as "hemodynamically effective." We analyzed the success rate for each criterion and determined factors which may have contributed to hemodynamic effectiveness. Results: Stenting was morphologically effective in all patients, while it was hemodynamically effective in 6/11 (55%). The percent diameter stenosis after stenting was significantly lower in the "hemodynamically effective" group (2.5 ± 5.5% vs 19.6 ± 13.1%, p = 0.017). The cutoff value of percent diameter stenosis after stenting to "hemodynamically effective" was 14.6%; the sensitivity was 80% and the specificity was 100% (area under the curve 0.825, p = 0.021). Conclusions: The percent diameter stenosis after stenting significantly contributed to achieving a "0 mmHg" pressure gradient, while in order to achieve a "0 mmHg" pressure gradient, the residual percent diameter stenosis should be less than around 15%.

Research paper thumbnail of Stenting for curved lesions using a novel curved balloon: Preliminary experimental study

Journal of cardiology, Jan 6, 2014

Stenting may be a compelling approach to dilating curved lesions in congenital heart diseases. Ho... more Stenting may be a compelling approach to dilating curved lesions in congenital heart diseases. However, balloon-expandable stents, which are commonly used for congenital heart diseases, are usually deployed in a straight orientation. In this study, we evaluated the effect of stenting with a novel curved balloon considered to provide better conformability to the curved-angled lesion. In vitro experiments: A Palmaz Genesis(®) stent (Johnson & Johnson, Cordis Co, Bridgewater, NJ, USA) mounted on the Goku(®) curve (Tokai Medical Co. Nagoya, Japan) was dilated in vitro to observe directly the behavior of the stent and balloon assembly during expansion. Animal experiment: A short Express(®) Vascular SD (Boston Scientific Co, Marlborough, MA, USA) stent and a long Express(®) Vascular LD stent (Boston Scientific) mounted on the curved balloon were deployed in the curved vessel of a pig to observe the effect of stenting in vivo. In vitro experiments: Although the stent was dilated in a curve...