Potential of Biodegradable Stents in Congenital Heart Disease

In the USA, approximately 40,000 newborns are diagnosed with congenital heart disease (CHD) annually, with about 1 in 4 of those having critical congenital heart disease requiring surgical or transcatheter intervention in the first year of life. Transcatheter interventions have become the first choice of treatment for certain indications in infancy and early childhood. Since the 1990s, stent placement has been increasingly used as a less invasive alternative to open-heart surgery for CHD treatment, but few stents have been developed specifically for use in infants and growing children. It is common to use adult stents as off-label for pediatric patients, but this is often limited by patient size and stent expansion potential. Currently, nearly all commercially available stents are made of metal and designed for permanent implantation in the vasculature, although bioresorbable polymers and biodegradable metals that allow the stent scaffold to degrade are attracting attention. This technology would allow for acute treatment of lesions in infants and small children without necessarily committing them to multiple future procedures to dilate or surgically open the stent as they grow. Because there are no bioresorbable stents that can be reliably used in pediatric patients with CHD at present, the search for the clinically useful bioresorbable stent platforms continues. This review discusses the potential of bioresorbable stents in the field of congenital heart disease, considering the current status of bioresorbable stents used in clinical settings.