title: Medium-term outcomes for peripheral pulmonary artery stenting in adults with congenital heart disease.
abstract: OBJECTIVE
  We describe our medium-term outcomes for peripheral pulmonary artery stenting in adults with congenital heart disease.
  
  
  BACKGROUND
  Improved outcomes in congenital heart disease have lead to the evolution of transcatheter therapies in adults aimed at maintaining normal hemodynamics. Stenting for pulmonary artery narrowing is effective in children, however little is known about outcomes in adults.
  
  
  METHODS
  Retrospective data analysis and follow-up review of our complete experience with peripheral pulmonary artery stenting in adults.
  
  
  RESULTS
  Over a 9-year period we carried out 15 procedures, implanting 23 stents (11-left pulmonary artery) in the pulmonary arteries of 12 adult patients (7 female). Eleven patients had previous cardiac surgery. Median age at implantation was 32.5 years (range, 18.7-56.7 years) with median weight of 71.3 kg (range, 44.5-95 kg). Six patients underwent bilateral pulmonary artery stenting. Median procedure time was 140 minutes (range, 76-263 minutes) and 4 patients had other interventions performed during the same procedure. Median systolic pressure gradient across the narrowing's of 24 mmHg (range, 11-61 mmHg) was reduced to 3 mmHg (range, 0-17 mmHg) postprocedure (P < 0.001). Three patients had acute stent embolization, one of whom required surgical removal. No aneurysm formation or significant stent fractures have been noted on median follow-up of 27.4 months (range, 1-97 months). Two patients required reintervention with further stent implantation.
  
  
  CONCLUSIONS
  Pulmonary artery stenting provides effective relief of narrowing in adults with congenital heart disease. Bilateral and/or multiple stenting are often required. Stent embolization may occur particularly in patients with associated significant pulmonary regurgitation. (J Interven Cardiol 2011;24:373-377).
authors.affiliation: Rush Center for Congenital and Structural Heart Disease, Rush University Medical Center, Chicago, Illinois, USA.
authors.forename: Damien
authors.initials: D
authors.lastname: Kenny
authors.forename: Zahid
authors.initials: Z
authors.lastname: Amin
authors.forename: Shari
authors.initials: S
authors.lastname: Slyder
authors.forename: Ziyad M
authors.initials: ZM
authors.lastname: Hijazi
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult