Transcatheter stent treatment for congenital peripheral pulmonary arterial stenosis.
A total of 5 Johnson and Johnson stents were implanted in two patients with significant residual peripheral pulmonary arterial stenosis. These were a 15-year-old boy with post-open heart surgery for tetralogy of Fallot and a 3 8/12 year-old boy with D-transposition of great vessels. Immediately after balloon dilatation and implantation of the stents, the diameter of the narrowing pulmonary arteries increased significantly from 6.0 +/- 0.8 mm to 13.5 +/- 1.7 mm (P < 0.001) and the systolic pressure gradients across the stenosis of peripheral pulmonary artery dropped significantly from 33.0 +/- 16.0 mmHg to 10.2 +/- 4.4 mmHg (P < 0.01). One year later, repeated cardiac catheterization was performed on both patients. In the patient with tetralogy of Fallot, a 20 mmHg pressure gradient was found between the main and left pulmonary artery. This patient then received another stent implantation to release the residual stenosis. The boy with D-transposition of great vessels had only 9 mmHg gradient between main and right pulmonary artery. Transcatheter placement of the stent is a feasible and effective method to treat certain patients with significant pulmonary arterial stenosis if surgical correction can not be performed.
Hwang
B
B
Department of Pediatrics, Venerans General Hospital-Taipei, Taiwan.
Lee
P C
PC
Fu
Y C
YC
Weng
Z C
ZC
Meng
L C
LC
D000293:Adolescent; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D011651:Pulmonary Artery / Q000002:abnormalities*; D015607:Stents