Stent implantation in the residual pulmonary artery stenosis in 5 children with congenital heart disease

  • Wei Gao, Department of Cardiology, Shanghai Children’s Medical Center ,School of Medicine, Shanghai ,Jiao Tong University,, China
  • Zhi-qing Yu, Department of Cardiology, Shanghai Children’s Medical Center ,School of Medicine, Shanghai ,Jiao Tong University,, China
  • Fen Li, Department of Cardiology, Shanghai Children’s Medical Center ,School of Medicine, Shanghai ,Jiao Tong University,, China
  • Mei-rong Huang, Department of Cardiology, Shanghai Children’s Medical Center ,School of Medicine, Shanghai ,Jiao Tong University,, China
  • Yun Li, Department of Cardiology, Shanghai Children’s Medical Center ,School of Medicine, Shanghai ,Jiao Tong University,, China
  • Jian-ping Yang, Department of Cardiology, Shanghai Children’s Medical Center ,School of Medicine, Shanghai ,Jiao Tong University,, China
  • Yu-min Zhong, Department of Cardiology, Shanghai Children’s Medical Center ,School of Medicine, Shanghai ,Jiao Tong University,, China
  • Yu-qi Zhang, Department of Cardiology, Shanghai Children’s Medical Center ,School of Medicine, Shanghai ,Jiao Tong University,, China

    • Objective: Balloon expandable stent placement in branch pulmonary arteries is limited by fragile hemodynamics during wire/sheath positioning and technical difficulties. Recent advances in delivery techniques and stent design have allowed the delivery of large stents, diliatable to adult size, through small sheaths. We report our short and mid-term results of branch pulmonary arteries stents implated in children.
    Methods: Stent implantation in the residual pulmonary artery stenosis with congenital heart disease was performed in 5 cases from 2005 to 2007. The age was 7 to 15 years. Stent delivery occurred through an 10~12F Mullins sheath or Amplatzer ASD delivery system on a BIB balloon (NuMed,Hopkinto,NY,USA)or a Z-Med balloon (B.Braun Medical Inc.,Bethelehem,PA). Follow up with echocardiography and clinical examination was done.
    Results: The CP stent (NuMed,Hopkinto,NY,USA)and Palmaz stent(Cordis J & J Interventional Sistems)were placed in the cath lab in 8 vessels. Mean minimum diameter of left and right branch pulmonary arteries increased from 5.5±1.3 mm,8.7±0.5 mm to 12.2±1.8mm and 16.0 ±2.6mm. mean pressure gradient decreased from 40±14.50 mmHg, 41.7±11.8 mmHg to 2.75± 0.83mmHg and 8.3±2.6mmHg. Major complications included stent migration to main pulmonary artery in one patient.
    Conclusion: Branch pulmonary arteries can be stented safely and effectively in small patients. Long term follow up is necessary to determine if these stents can be dilated to adult size.
    Keywords: pulmonary artery stenosis ; interventional therapeutic; stents