title: Pulmonary artery branch stenosis in patients with congenital heart disease.
abstract: OBJECTIVE
  We sought to evaluate our recent experience with surgical treatment of branch pulmonary artery (PA) stenosis both for native and acquired lesions.
  
  
  METHODS
  The postoperative course of patients who underwent surgical PA plasty augmentation between January 2004 and January 2012 were reviewed. Primary outcomes included the need for further surgical procedures or interventional maneuvers on the branch PAs for residual stenosis.
  
  
  RESULTS
  Thirty-four patients were included. Median age at PA plasty was eight months (range 8 days to 3.4 years). There were 12 native and 22 acquired PA stenoses, which were mainly located at the PA branch origin (n = 25, 73%). The PA plasty was defined as simple (n = 16, 47%) and as complex (n = 18, 53%), which included multiple maneuvers on the PA branches. Median follow-up time after surgical treatment was 4.7 years (range 0.9 to 8.7 years). One patient died 3 days after complex PA plasty for low output syndrome and another died 22 months later for congestive heart failure. Twenty-one (63.6%) underwent 40 catheter intervention procedures on the PA branches for residual stenosis. The majority of them (n = 10, 57.1%) were operated before the age of six months and the majority had an acquired PA stenosis (14, 66.7%). Three patients underwent additional surgical maneuvers on the PA branches.
  
  
  CONCLUSIONS
  PA branch stenosis represents a life-threatening condition often necessitating further surgical or interventional treatment. A combined collaborative surgical followed by transcatheter approach is important, particularly in cases with an acquired PA stenosis who require complex surgical repair.
authors.affiliation: Department of Thoracic, Cardiac and Vascular Sciences, Pediatric and Congenital Cardiac Surgery Unit, Padua, Italy. vladimirovida@yahoo.it
authors.forename: Vladimiro L
authors.initials: VL
authors.lastname: Vida
authors.forename: Mauro Lo
authors.initials: ML
authors.lastname: Rito
authors.forename: Fabio
authors.initials: F
authors.lastname: Zucchetta
authors.forename: Roberta
authors.initials: R
authors.lastname: Biffanti
authors.forename: Massimo A
authors.initials: MA
authors.lastname: Padalino
authors.forename: Ornella
authors.initials: O
authors.lastname: Milanesi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Stellin
mesh_terms: D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000151:congenital*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011651:Pulmonary Artery / Q000473:pathology* / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods