title: Morphological and Hemodynamic Effectiveness of Stenting for Pulmonary Artery Stenosis　- Subanalysis of JPIC Stent Survey.
abstract: BACKGROUND
  Percutaneous stenting for branch pulmonary artery stenosis is an established interventional choice in congenital heart disease. The apparent morphologic change in the vessel diameter often differs from the hemodynamic result.
  
  
  RESULTS
  We performed a subanalysis of the data from the Japanese Society of Pediatric Interventional Cardiology (JPIC) stent survey. The factors that may have contributed to morphologic effectiveness included reference vessel diameter (RVD), minimum lumen diameter (MLD) and percent diameter stenosis (%DS) and the relation between morphologic and hemodynamic effectiveness was evaluated in 206 lesions treated with stenting. We defined a "50% increase in MLD" as "morphologically effective", while "achievement of either a reduced pressure gradient greater than 50% or an increase of perfusion ratio to the affected side to the contralateral side greater than 20%" as "hemodynamically effective". Morphologic effectiveness was achieved in 84% of patients. Before stenting, %DS was significantly larger, while RVD was smaller in the "effective" group than in the "non-effective" group. The cutoff value for effective stenting was 51% for %DS and 14.7 mm for RVD before stenting. Hemodynamic effectiveness was obtained more often in the "morphologic effective" group.
  
  
  CONCLUSIONS
  RVD and %DS were the 2 main contributors to acute morphologic effectiveness. There was a significant relationship between "morphologic effectiveness" and "hemodynamic effectiveness", judging from increased perfusion of the affected lung and/or decreased pressure gradient. (Circ J 2016; 80: 1852-1856).
authors.affiliation: Cardiovascular Center, Showa University Northern Yokohama Hospital.
authors.forename: Takanari
authors.initials: T
authors.lastname: Fujii
authors.forename: Hideshi
authors.initials: H
authors.lastname: Tomita
authors.forename: Kazuto
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Shinichi
authors.initials: S
authors.lastname: Otsuki
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ono
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yazaki
authors.forename: Sung-Hae
authors.initials: SH
authors.lastname: Kim
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakanishi
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D008297:Male; D000071079:Stenosis, Pulmonary Artery / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D015607:Stents; D011795:Surveys and Questionnaires