title: A novel technique for stenting pulmonary artery and conduit bifurcation stenosis.
abstract: BACKGROUND
  Distal conduit obstruction is a recognized complication after surgery for congenital heart disease requiring implantation of a conduit from the right ventricle to the pulmonary arteries. Endovascular stenting of distal conduit obstruction can be challenging due to the proximity to the pulmonary artery bifurcation.
  
  
  OBJECTIVE
  A technique is described, whereby a single stent is mounted onto two balloon angioplasty catheters in tandem. This ensemble was delivered to the distal conduit/pulmonary artery via a large Mullins sheath on two guidewires, one placed in each of the branch pulmonary arteries. The aim was to assess safety and efficacy of this novel technique.
  
  
  RESULTS
  Seven patients (mean age 13.4 (6.7-23.4) years, mean weight 44.2 (23-69) kg were treated with this method. The pressure gradient was reduced from 36 (26-52) mm Hg to 11 (8-15) mm Hg [P< 0.05]. RV/LV pressure ratio decreased from 0.85 (0.6-0.95) to 0.42 (0.35-0.5) [P < 0.05]. There were no significant complications. During follow-up over a median of 2.6 (0.3-6.7) years no patient required re-intervention or surgery.
  
  
  CONCLUSIONS
  This novel technique appears to be safe and effective for stenting stenoses just proximal to pulmonary artery bifurcation.
authors: Heart Unit, Birmingham Children's Hospital, United Kingdom. oliver.stumper@bch.nhs.uk
authors: Oliver
authors: O
authors: Stumper
authors: Vinay
authors: V
authors: Bhole
authors: Ben
authors: B
authors: Anderson
authors: Zdenka
authors: Z
authors: Reinhardt
authors: Patrick
authors: P
authors: Noonan
authors: Chetan
authors: C
authors: Mehta
mesh_terms: D000293:Adolescent; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D001794:Blood Pressure; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D057785:Catheters; D002648:Child; D003251:Constriction, Pathologic; D004739:England; D004867:Equipment Design; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D011474:Prosthesis Design; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome; D017725:Ventricular Pressure; D055815:Young Adult