title: Stenting for pulmonary artery stenosis complicated by univentricular physiology: subanalysis of JPIC stent survey.
abstract: OBJECTIVE
  Stent implantation is an important treatment option for pulmonary artery stenosis (PS), even if complicated by univentricular physiology (UVP). However, there is paucity of evidence concerning not only its hemodynamic and morphologic indications but also on markers for its optimal target attainment in UVP. The purpose of this study was to evaluate the acute outcome and factors associated with efficacy of stenting for PS complicating UVP.
  
  
  METHODS
  A subanalysis was performed using the data of the Japanese Society of Pediatric Interventional Cardiology (JPIC) stent survey. We analyzed the morphologic and hemodynamic data of 11 patients with UVP who underwent stenting for PS. We defined "a 50% increase in the minimum lumen diameter (MLD)" as "morphologically effective," and "an achievement of 0 mmHg pressure gradient" as "hemodynamically effective." We analyzed the success rate for each criterion and determined factors which may have contributed to hemodynamic effectiveness.
  
  
  RESULTS
  Stenting was morphologically effective in all patients, while it was hemodynamically effective in 6/11 (55%). The percent diameter stenosis after stenting was significantly lower in the "hemodynamically effective" group (2.5 ± 5.5% vs 19.6 ± 13.1%, p=0.017). The cutoff value of percent diameter stenosis after stenting to "hemodynamically effective" was 14.6%; the sensitivity was 80% and the specificity was 100% (area under the curve 0.825, p=0.021).
  
  
  CONCLUSIONS
  The percent diameter stenosis after stenting significantly contributed to achieving a "0 mmHg" pressure gradient, while in order to achieve a "0 mmHg" pressure gradient, the residual percent diameter stenosis should be less than around 15%.
authors.affiliation: Cardiovascular Center, Showa University Northern Yokohama Hospital, Yokohama City, Kanagawa, Japan. Electronic address: takanari@nn.iij4u.or.jp.
authors.forename: Takanari
authors.initials: T
authors.lastname: Fujii
authors.affiliation: Cardiovascular Center, Showa University Northern Yokohama Hospital, Yokohama City, Kanagawa, Japan.
authors.forename: Hideshi
authors.initials: H
authors.lastname: Tomita
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Okayama University, Okayama, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Otsuki
authors.affiliation: Department of Pediatric Cardiology, Saitama Medical University International Medical Center, Saitama, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Cardiology, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ono
authors.affiliation: Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yazaki
authors.affiliation: Department of Cardiology, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Sung-Hae
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Pediatric Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakanishi
mesh_terms: D000293:Adolescent; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications*; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D008297:Male; D011651:Pulmonary Artery; D011652:Pulmonary Circulation; D015607:Stents
keywords: Congenital heart disease; Interventional cardiology; Pulmonary artery; Stent