Objectives: Determine the outcomes of branch pulmonary artery (PA) stents.
Background: Pulmonary artery stenosis exists as a spectrum. It varies from localized stenosis occurring in one or both branches at one end of the spectrum to more diffuse widespread bilateral stenoses at the other. Very often a localized stenosis is associated with post-stenotic dilatation, whereas diffuse tubular narrowing may not have post-stenotic dilatation. The stenosis can occur either at the origin or more peripherally beyond the hilar branches. The stenosis is commonly congenital in origin occurring either as an isolated anomaly or in association with other congenital heart defects. It can also occur following a previous attempt at surgical repair. It is most frequently seen in children with pulmonary atresia with ventricular septal defect or more complex anomalies with single ventricle physiology.
Methods: we present our experience in 26 patients with stent implantation in ductus arteriosus and branch pulmonary arteries.
Results: The procedure was successful in all patients resulting in a significant reduction in the post-operative gradients. This approach avoids difficult surgery on fragile pulmonary arteries, recruits pulmonary arteries, maintains their patency and makes them amenable to future percutaneous or surgical interventions.
Conclusion: with continuing developments and refinements in the technology and increasing experience with these techniques, the safety profile of stenting of branch pulmonary arteries should improve even further. Although surgeons can deal with proximal branch pulmonary artery stenosis, there is a high probability of recurrence. Moreover, surgeons are unable to deal with stenosis beyond the hilum. Stents can be implanted at all ages with excellent and predictable results.
