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. 2012 Jan;42(1):40-5.
doi: 10.4070/kcj.2012.42.1.40. Epub 2012 Jan 31.

Effectiveness and safety of percutaneous transcatheter implantation of pulmonary arterial stent in congenital heart disease

Hong Ki Ko  1 , Young-Hwue Kim, Jeong Jin Yu, Jae-Kon Ko, In-Sook Park, Dong-Man Seo, Tae-Jin Yun, Jeong-Jun Park, Wan Sook Jang
Affiliations

Effectiveness and safety of percutaneous transcatheter implantation of pulmonary arterial stent in congenital heart disease

Hong Ki Ko et al. Korean Circ J. 2012 Jan.

Abstract

Background and objectives: Pulmonary arterial stenosis is a relatively common complication after corrective operation of congenital heart disease. Unilateral stenosis of pulmonary arteries could result in decrease perfusion of affected lung, pulmonary regurgitation, or elevation of right ventricular pressure. Eventually there are increasing risks of right ventricular failure, arrhythmia, or sudden death. However we have limited data of pulmonary arterial stent in paediatric population as the treatment of branch pulmonary stenosis. This study aimed at validating the effectiveness and investigating complications of pulmonary arterial stent implantation in a single institution during mid-term follow up period.

Subjects and methods: A total of 42 patients (50 stents) were implanted for treating branch pulmonary arterial stenosis. We used cardiac catheterization for comparing diameter after stent implantation directly and lung perfusion scan indirectly. We also investigated any adverse effect relating the procedure.

Results: Percent stenosis of stenotic lesions were decreased from 54.1±10.7% to 22.8±12.5% (p<0.001) and degree of decrement in affected lung perfusion was declined from 22.7±8.0% to 10.3±9.0% (p<0.001) immediately and lasts during mid-term follow up period. Complication rate relating the procedure was 12% (6 out of 12) and there was no mortality case.

Conclusion: This series showed immediate and short term effectiveness of pulmonary arterial stent in congenital heart defects. We concluded that percutaneous transcatheter implantation of pulmonary arterial stent was safe and effective during short and mid-term follow up period.

Keywords: Catheterization; Congenital heart disease.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
Double wire technique in stenosis of both pulmonary arteries. This still frame image shows that two wires were located at both sides of pulmonary arteries for simultaneous ballooning of the stents. A: sit-up view. B: lateral view.
Fig. 2
Fig. 2
Extra-balloon widening of proximal stent for easy-approach. This image showed ballooning (A) of proximal part of stent after implantation first, which made it easier and safer to access distal pulmonary artery next time. Wide opened stent is shown (B).
Fig. 3
Fig. 3
Changes in diameter of pulmonary arterial stenosis and in percent stenosis. This represents increase of diameter in stenotic lesion and decrease of percent stenosis after stent implantation significantly among almost patients.
Fig. 4
Fig. 4
Complications of implantation of pulmonary artery stent. A: after implanting stent vascular leakage was noted (left) then it was repaired by Jostent® Graft Master. After graft implantation within stent, no leakage was found on angiography (right). B: this showed that stent fracture at proximal part of stent was found during follow-up catheterization for evaluating re-stenosis of left pulmonary artery.
See this image and copyright information in PMC

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