title: Cutting balloon angioplasty for children with small-vessel pulmonary artery stenoses.
abstract: Patients with complex congenital heart disease may have pulmonary artery stenoses that are either congenital or associated with scarring following surgical procedures. This study evaluates cutting balloon angioplasty for small-vessel pulmonary artery stenoses resistant to standard balloon angioplasty. Between October 1998 and December 1999, patients were enrolled in an FDA-approved compassionate-use protocol. During four catheterizations, there were seven lesions found resistant to standard balloon angioplasty (mean lesion diameter was unchanged: 1.8 mm +/- 0.8 mm to 1.9 +/- 0.8 mm). A cutting balloon was inflated twice in each of these lesions. Standard balloon angioplasty was then repeated. Final mean lesion diameter was increased significantly (1.9 mm +/- 0.8 mm to 3.8 +/- 1.3 mm; P <or= 0.01). Follow-up catheterizations performed a median of 14 months later showed only slight decrease in mean lesion diameter (3.2 +/- 1.2 mm), still significantly greater than initial mean lesion diameter (P < 0.03). In conclusion, cutting balloon angioplasty for pulmonary artery stenoses resistant to standard balloon angioplasty improves the immediate and intermediate term results of angioplasty for these lesions.
authors.affiliation: Department of Pediatric Cardiology, The Cleveland Clinic Foundation, Center for Pediatric and Congenital Heart Diseases, Cleveland, Ohio 44195, USA. rhodesj1@ccf.org
authors.forename: John F
authors.initials: JF
authors.lastname: Rhodes
authors.forename: Geoffrey K
authors.initials: GK
authors.lastname: Lane
authors.forename: C Igor
authors.initials: CI
authors.lastname: Mesia
authors.forename: J Donald
authors.initials: JD
authors.lastname: Moore
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Nasman
authors.forename: Denise A
authors.initials: DA
authors.lastname: Cowan
authors.forename: Larry A
authors.initials: LA
authors.lastname: Latson
mesh_terms: D000800:Angioplasty, Balloon / Q000379:methods*; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic; D006330:Heart Defects, Congenital / Q000473:pathology*; D006801:Humans; D011651:Pulmonary Artery / Q000473:pathology*