caa a22 4500 44582509X CHVBK 20180317145256.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s00246-010-9870-y doi (NATIONALLICENCE)springer-10.1007/s00246-010-9870-y Histopathologic Evaluation of Patent Ductus Arteriosus Stents After Hybrid Stage I Palliation [Elektronische Daten] [Matthew Egan, Aaron Trask, Peter Baker, Jonathan Lawrence, Elena Ladich, Renu Virmani, Sharon Hill, John Cheatham, Mark Galantowicz, Pamela Lucchesi, John Kovalchin] The aim of this study was to determine the histopathology of patent ductus arteriosus (PDA) in-stent stenosis after hybrid stage I palliation. The hybrid approach to palliation of hypoplastic left heart syndrome can be complicated by the development of in-stent stenosis of the PDA. This may obstruct retrograde aortic arch flow, decrease systemic circulation, and lead to interstage interventional procedures. Stented PDA samples removed from eight patients undergoing comprehensive stage II repair were examined by way of radiography and histochemistry (hematoxylin and eosin, Movat pentachrome, α-smooth muscle actin, and proliferating cell nuclear antigen). A retrospective chart review of the patients was also performed. PDA stents were in place in the PDA for a mean period of 169±28days in patients who had a mean age of 176±30days at the time of stent removal. Stent deployment caused chronic inflammation, caused fibrin deposition, and induced vascular smooth muscle-cell (VSMC) proliferation in the area immediately surrounding the stent struts. The neointimal region was composed largely of smooth muscle cells that appeared to be fully differentiated by the lack of PCNA staining. Neointimal thickening occurs in the PDA after stent placement for hybrid palliation of HLHS and is the result of inflammation, extracellular matrix deposition, and smooth muscle-cell proliferation in the peristrut region. This finding suggests that proliferating VSMCs in the peristrut region may provide the impetus for inward neointimal formation and therefore the manifestation of in-stent stenosis. Springer Science+Business Media, LLC, 2011 Ductus arteriosus nationallicence Stent nationallicence Neointima nationallicence In-stent stenosis nationallicence Egan Matthew The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut Trask Aaron The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut Baker Peter Department of Pathology, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut Lawrence Jonathan The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut Ladich Elena CVPath Institute, Gaithersburg, MD, USA aut Virmani Renu CVPath Institute, Gaithersburg, MD, USA aut Hill Sharon The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut Cheatham John The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut Galantowicz Mark The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut Lucchesi Pamela The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut Kovalchin John The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut Pediatric Cardiology Springer-Verlag 32/4(2011-04-01), 413-417 0172-0643 32:4<413 2011 32 246 https://doi.org/10.1007/s00246-010-9870-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00246-010-9870-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Egan Matthew The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Trask Aaron The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Baker Peter Department of Pathology, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Lawrence Jonathan The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Ladich Elena CVPath Institute, Gaithersburg, MD, USA aut NATIONALLICENCE 700 1- Virmani Renu CVPath Institute, Gaithersburg, MD, USA aut NATIONALLICENCE 700 1- Hill Sharon The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Cheatham John The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Galantowicz Mark The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Lucchesi Pamela The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Kovalchin John The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 43205, Columbus, OH, USA aut NATIONALLICENCE 773 0- Pediatric Cardiology Springer-Verlag 32/4(2011-04-01), 413-417 0172-0643 32:4<413 2011 32 246 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer