Catheterization Treatment of Stenosis and Hypoplasia of Pulmonary Arteries

Abstract

Stenosis of pulmonary arteries is one of the most challenging problems requiring treatment in the care of patients with congenital and acquired cardiopulmonary disease. Surgical approaches have been met with difficulty over the years, and may themselves lead to further distortion of the treated arteries. Balloon dilation first came into use in the 1980s, and has proved moderately effective. Its use has been extended to proximal pulmonary valve stenosis in order to improve distal flow and artery growth in some variants of tetralogy of Fallot. More recently, the judicious application of stent implantation has improved the outlook for pulmonary artery stenosis. The etiology, treatment (with balloon dilation and stent placement), and prognosis of pulmonary arterial stenosis will be discussed.

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease

“…426 When restenosis does occur, it may respond to redilation. Stents have proved effective compared with either percutaneous angioplasty or surgical intervention in this situation.…”

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: Executive Summary

“…107 Stenting of branch PS has also been used in the operating room as adjunctive therapy. The use of balloon angioplasty and stenting may also be applied to more distal peripheral PS, although the results have generally been less impressive than with branch stenosis.…”

Adult Congenital Heart Disease

“…53 Stenting of pulmonary branch stenosis is also feasible. 134 Otherwise, most reintervention is surgical. 135 Adult patients with good surgical results and no complications often have minimal symptoms, 130 and some can be active.…”