Balloon angioplasty--branch pulmonary artery stenosis: results from the Valvuloplasty and Angioplasty of Congenital Anomalies Registry.
Balloon angioplasty for branch pulmonary artery stenosis was reported from 27 institutions to the Valvuloplasty and Angioplasty of Congenital Anomalies Registry. One hundred eighty-two procedures were performed in 156 patients ranging in age from 0.2 to 46.2 years (mean 7.7). Short-term angiographic appearance, hemodynamic results and immediate complications were recorded. Vessel dimension at the site of stenosis increased from 4.5 +/- 2.0 (mean +/- standard deviation) to 6.8 +/- 3.0 mm (p less than 0.001) with greater increases in vessel dimension at the site of stenosis if the balloon diameter was greater than 3 X the original dimension of the stenosis. There was no significant benefit related to age or prior surgical intervention. The mean peak systolic pressure gradient was reduced from 49 +/- 25 to 37 +/- 26 mm Hg (p less than 0.001) and pressure proximal to the stenosis decreased from 69 +/- 25 to 63 +/- 24 mm Hg (p less than 0.001). Complications occurred in 21 patients and included vessel rupture and death in 2 patients, vessel perforation or rupture with survival in 3, cardiac arrest and death in 1, paradoxical embolism and death in 1 and low output and death in 1. Balloon angioplasty for branch pulmonary artery stenosis increases vessel dimension at the site of stenosis, reduces systolic pressure gradient and to a minor degree, reduces proximal pressure. Long-term outcome and potential complications are as yet uncertain.
Kan
J S
JS
Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.
Marvin
W J
WJ
Bass
J L
JL
Muster
A J
AJ
Murphy
J
J
D002404:Catheterization / Q000009:adverse effects; D002648:Child; D003251:Constriction, Pathologic / Q000151:congenital / Q000628:therapy; D006330:Heart Defects, Congenital / Q000628:therapy*; D006801:Humans; D011651:Pulmonary Artery; D012042:Registries; D014481:United States