Background Stenosis of the pulmonary arteries frequently occurs during staged palliation of hypoplastic left heart syndrome and variants, often necessitating stent angioplasty. A complication of stent angioplasty is compression of the ipsilateral main-stem bronchus. Following such a case, we re-evaluated our approach to PA stent angioplasty in these patients. Methods The incident case is described. A retrospective observational study of children and adults with superior(SCPC) and/or total cavopulmonary connection(TCPC) undergoing left pulmonary artery (LPA) stent angioplasty between 1/1/2005 and 5/1/2014 and subsequent chest CT was performed to assess the incidence of bronchial compression. The current strategy of employing bronchoscopy to assess bronchial compression during angioplasty is described with short-term results. Results 65 children and adults underwent LPA stent angioplasty. Other than the incident case, none had symptomatic bronchial compression. Of the total study population, 12% had subsequent CT, of which 1 subject had moderate bronchial compression. To date, 7 subjects have undergone angioplasty of LPA stenosis and bronchoscopy. In one case, stent angioplasty was not performed because of baseline bronchial compression, exacerbated during angioplasty. In the rest of cases, mild-moderate compression was seen during angioplasty. Following stent angioplasty, the resultant compression was not worse than that seen on test angioplasty. Conclusion Bronchial compression is a rare complication of stent angioplasty of the pulmonary arteries in children and adults with SCPC/TCPC. Angioplasty of the region of interest with procedural bronchoscopy can help to identify patients at risk of this complication.
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