title: Clinical impact of balloon angioplasty for branch pulmonary arterial stenosis.
abstract: The clinical impact of percutaneous balloon angioplasty on the management of patients with native or postoperative pulmonary arterial stenosis was reviewed. Seventy-four patients underwent 110 angioplasty procedures. Mean age at dilation was 6.7 +/- 5.3 years (range 0.2 to 18.1), 17 patients were aged less than 1 year, mean follow-up was 37.7 +/- 22.8 months (range 16 to 96), and 34 patients (44%) had follow-up angiography. Pulmonary artery dilation was acutely successful in 53% of patients, 17% had recurrent stenosis, and 5% had complications. The impact on subsequent care was favorably influenced in 26 of 74 patients (35%) with either complete resolution of stenosis (n = 7), optimizing future surgical conditions (n = 14), reduction in right ventricular pressure by greater than 20% (n = 3), or improvement of ipsilateral lung perfusion (n = 2). No patient previously considered inoperable was subsequently considered suitable for surgical repair owing to the intervention. No correlation was found between success and cardiac diagnosis (p = 0.48), site of stenosis (p = 0.78), balloon-vessel ratio (p = 0.42), or whether the stenotic area consisted of native or synthetic material (p = 0.22). No predictive factors for success could be defined, and often there was only a transient clinical impact. Due to the low complication risk and potential for a beneficial result, it still appears prudent to offer angioplasty as an initial therapeutic modality in this setting.
authors.affiliation: Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: M C
authors.initials: MC
authors.lastname: Hosking
authors.forename: C
authors.initials: C
authors.lastname: Thomaidis
authors.forename: R
authors.initials: R
authors.lastname: Hamilton
authors.forename: P E
authors.initials: PE
authors.lastname: Burrows
authors.forename: R M
authors.initials: RM
authors.lastname: Freedom
authors.forename: L N
authors.initials: LN
authors.lastname: Benson
mesh_terms: D000293:Adolescent; D000800:Angioplasty, Balloon / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000628:therapy; D003251:Constriction, Pathologic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000628:therapy; D011651:Pulmonary Artery / Q000002:abnormalities / Q000473:pathology*