Pulmonary Artery Branch Stenosis in Patients with Congenital Heart Disease

Abstract

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.

Consequences of an early catheter‐based intervention on pulmonary artery growth and right ventricular myocardial function in a pig model of pulmonary artery stenosis

“…Finally, our data showed that the RV undergoes subtle functional remodeling that persists after successful interventions. intervention rates as high as 50-65% [5,6] with an increased cumulative risk with each re-operation [3,4]. Balloon angioplasty can be effective, but often requires large balloon-to-stenosis diameters to be efficacious, increasing the risk of vascular complications and postoperative PA stenosis frequently does not respond to balloon dilation alone.…”

Combined Surgical and Interventional Approaches for Treating Patients with Congenital Heart Disease

“…During the last few years, we have further promoted the applicability of new CCBSI techniques in selected patients, and we have further extended the concept of interaction between cardiologists and cardiac surgeons both in the operating room, and in the catheterization laboratory, that is, with the combined transinfundibular balloon dilation of the pulmonary trunk following pulmonary artery banding and the transventricular VSD closure without the need of CPB, or the intraoperative balloon dilation of the pulmonary artery branches in patients with central stenosis, after initial palliative staged approach (i.e., systemic‐to‐pulmonary shunts, PDA stenting etc. ).…”

Intraoperative Stenting of Pulmonary Artery Stenosis in Children With Congenital Heart Disease

“…In these patients, stents helped to prevent early postoperative recurrence, compression, or kinking of the repaired PA. Surgical angioplasty of PAs is associated with a high risk of stenosis. Vida and colleagues [2] reported that 21 of 33 (64%) patients who underwent surgical angioplasty of PAs needed interventional maneuvers on PA branches for residual stenosis. Ten of them (30%) required stenting (median time interval of 5.3 months after surgery).…”

“…Management of BPA stenosis is challenging for surgeons and interventional cardiologists. Fifty to 60% of patients present recurrent stenosis following surgical angioplasty of pulmonary arteries (PAs) [1,2]. Furthermore, surgery may be difficult in cases of dilated aorta, dense adhesions, excessive pulmonary blood flow from collaterals, and distal PA stenosis.…”