Advancing Minimally Invasive Options for the Smallest Patients

Within the Heart Institute at Cincinnati Children’s, the Cardiac Catheterization and Intervention program uses advanced, minimally invasive techniques to diagnose and treat heart conditions. If Shabana Shahanavaz, MD, MBBS, director of the Cardiac Catheterization Laboratory, had to summarize the program’s purpose in one word, it would be “advancing.”

“We’re involved with a lot of advancing, trying to develop newer techniques and devices that delay surgery or get minimally invasive options to our patients to avoid multiple surgeries,” she says.

Two recent advancements include the Renata Minima stent and minimally invasive transcatheter stage 1 palliation.

Early Involvement with the Minima Heart Stent

Shahanavaz and her team were involved with the Minima stent early on—starting with the multicenter early feasibility trial that ultimately led to the FDA approval of the stent in August 2024. Cincinnati Children’s was the second institution to implant the stent as part of the study.

“We enrolled multiple patients, successfully implanted the stent in all patients we enrolled, and had great outcomes without the need for multiple re-interventions or surgery,” Shahanavaz says. “Some of these patients have benefitted from the stent to the point that they’ve avoided surgery for the last four years since implantation.”

The Minima stent was designed for interventional cardiologists to implant in infants with congenital heart defects where the pulmonary arteries that carry blood from the heart to the lungs are too narrow, or the aorta is too narrow to carry blood from the heart to the rest of the body. Until now, cardiologists had to alter adult stents to fit a baby’s tiny vessels and then replace them as the child grows older.

With the Minima stent, cardiologists can expand it using minimally invasive methods, replacing the previous need for multiple invasive surgeries as a baby grows into adulthood. NBC News covered the Minima stent’s approval and reached out to Shahanavaz for comment.

“I have been an interventional cardiologist for 15 years now,” Shahanavaz said. “In that time, we have never had a stent that has been manufactured specifically to be safe when used in a baby. This simple technology, once placed in an infant, can be dilated up to an adult size. It’s mind boggling to think we didn’t have that before.”

A New Approach: Minimally Invasive Transcatheter Stage 1 Palliation

In addition to using the Minima stent, Cincinnati Children’s is one of only a few centers offering minimally invasive transcatheter stage 1 palliation for patients with congenital heart disease who have high-risk lesions and do not qualify for surgery, or surgery is higher risk. The goal of this hybrid technique is to regulate blood flow and reduce the need for high-risk surgeries, especially in neonates.

So far, Shahanavaz and her team have used this technique to place flow restrictor devices and ductal stents in several patients, with positive results.

“We’ve had successful procedures with these patients and have avoided neonatal interventions,” she says. “Some have transitioned to be better surgical candidates when they go through their neonatal period.”

Continuous Care Improvements with New Techniques and Devices

The Cardiac Catheterization and Intervention program continues to pursue new techniques and devices to ensure that patients always receive the best care possible in the least invasive way.

“Historically, the primary option has been repeated surgeries,” says Shahanavaz. “But with these newer techniques and devices, patients may not require as many open-heart procedures. As a result, they’ll have better long-term outcomes from the lack of multiple invasive surgeries.”

As a high-volume center that sees pathologies from at least three states, Cincinnati Children’s continues to attract both new patients and companies trialing innovative devices. With the support staff and multidisciplinary teams required to take care of complex patients, along with the facilities to support larger research studies, this program is well-equipped to continue advancing pediatric heart care.

(Published December 2025)

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