Risk factors for persistence of pulmonary arterial branch stenosis in neonates and young infants

Nomura, Yoshio; Nakamura, Makoto; Kono, Yukiharu; Fukushige, Tomoko; Shimago, Atsushi; Kamimura, Junko; Nishi, Junichiro; Yoshinaga, Masao; Miyata, Koichiro

doi:10.1046/j.1442-200x.2001.01342.x

Cited by 4 publications

(3 citation statements)

References 7 publications

(24 reference statements)

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“…Pulmonary arterial branch stenosis is generally considered a transient phenomenon in neonates and young infants. It does however persist beyond a year in a minority of cases, and this persistence is related to IUGR but not prematurity 87 . IUGR, as measured by ponderal index for gestational age, is also associated with an increased incidence and severity of persistent pulmonary hypertension of the newborn 88 .…”

Section: Consequences Of Iugr For Childhood and Adult Respiratory Mormentioning

confidence: 93%

Long term respiratory consequences of intrauterine growth restriction

Pike

Pillow

Lucas

2012

Seminars in Fetal and Neonatal Medicine

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Epidemiological studies demonstrate that in-utero growth restriction and low birth weight are associated with impaired lung function and increased respiratory morbidity from infancy, throughout childhood and into adulthood. Chronic restriction of nutrients and/or oxygen during late pregnancy causes abnormalities in the airways and lungs of offspring, including smaller numbers of enlarged alveoli with thicker septal walls and basement membranes. The structural abnormalities and impaired lung function seen soon after birth persist or even progress with age. These changes are likely to cause lung symptomology through life and hasten lung aging.

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Section: Consequences Of Iugr For Childhood and Adult Respiratory Mormentioning

confidence: 93%

Long term respiratory consequences of intrauterine growth restriction

Pike

Pillow

Lucas

2012

Seminars in Fetal and Neonatal Medicine

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“…The published literature on the natural history of PPS includes few patients with severe PPS. [4][5][6][7][8] In the natural history study reported by Wren et al, only 7 of 35 patients had an RV pressure ≥50 mm Hg; in 5 of those 7, the RV pressure was observed to decrease spontaneously (without any interventions) by up to 40 mm Hg during the first several years of life. 6 It is possible that some of the patients in our series would have experienced similar improvements in RV pressure without intervention.…”

Section: Assessment Of Interventionmentioning

confidence: 97%

“…[1][2][3] Reports of single cases or small series have suggested that PPS may improve over time without intervention, but these studies included few patients with severe disease, which may limit their applicability to patients who are generally considered for PA intervention. [4][5][6][7][8] As with branch PA stenosis associated with other conditions, transcatheter intervention has become an accepted mode of therapy for patients with hemodynamically important PPS. Angioplasty and stent implantation have been shown to increase vessel diameter and decrease RV pressure in patients with PA stenosis in various clinical circumstances.…”

mentioning

confidence: 99%

Outcomes After Primary Transcatheter Therapy in Infants and Young Children With Severe Bilateral Peripheral Pulmonary Artery Stenosis

Cunningham

McElhinney

Bergersen

et al. 2013

Circ: Cardiovascular Interventions

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Patients with bilateral PPS, who underwent transcatheter intervention at Children's Hospital Boston at ≤5 years of age from July 1984 through July 2009, were ascertained from the computer database of the Department of Cardiology. This series does not include patients with PA stenosis in the context of other anomalies, such as tetralogy of Fallot, truncus arteriosus, transposition of the great arteries, single ventricle heart disease, congenitally discontinuous PAs, or patients with congenital rubella. Patients with isolated atrial or ventricular septal defects, or systemic arterial disease (eg, supravalvar aortic Background-Angioplasty and stent implantation have become accepted therapies for isolated peripheral pulmonary stenosis, and have been shown to increase vessel diameter and reduce right ventricular (RV) pressure acutely in patients with pulmonary artery (PA) stenosis. The purpose of this study was to assess long-term outcomes after primary transcatheter therapy for peripheral pulmonary stenosis. Methods and Results-We studied 69 patients who underwent primary transcatheter intervention for severe isolated peripheral pulmonary stenosis at ≤5 years of age. Genetic/syndromic diagnoses included Williams syndrome (n=23), non-Williams familial arteriopathy (n=12), and Alagille syndrome (n=3). At the initial PA intervention, median RV:aortic pressure ratio decreased from 1.00 to 0.88 (median decrease, 0.18; P<0.001). Patients with a higher preintervention RV:aortic pressure ratio had a greater reduction (P<0.001). During follow-up (median, 8.5 years), 10 patients died, 5 from complications of PA catheterization (all before 1998). Thirteen patients underwent surgical PA intervention, most within 1 year and along with repair of supravalvar aortic stenosis. Freedom from any PA reintervention was 38±6% at 1 year and 22±6% at 5 years. The median RV:aortic pressure ratio decreased from 1.0 at baseline to 0.53 at the most recent catheterization (P<0.001), and 82% of patients with available clinical follow-up were asymptomatic. Conclusions-Transcatheter therapy for infants with severe peripheral pulmonary stenosis has become safer, regardless of genetic condition. Coupled with reintervention and surgical relief in selected cases, RV:aortic pressure ratios decrease substantially and most patients are asymptomatic at late follow-up. (Circ Cardiovasc Interv. 2013;6:460-467.)

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Pulmonary Stenosis

Keane¹,

Fyler²

2006

Nadas' Pediatric Cardiology

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Risk factors for persistence of pulmonary arterial branch stenosis in neonates and young infants

Cited by 4 publications

References 7 publications

Long term respiratory consequences of intrauterine growth restriction

Long term respiratory consequences of intrauterine growth restriction

Outcomes After Primary Transcatheter Therapy in Infants and Young Children With Severe Bilateral Peripheral Pulmonary Artery Stenosis

Pulmonary Stenosis

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