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Expanding indications for the treatment of pulmonary artery stenosis in children by using cutting balloon angioplasty
Author(s) -
Butera Gianfranco,
Antonio La Torre Marco,
Massimo Chessa,
Mario Carminati
Publication year - 2006
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20657
Subject(s) - medicine , angioplasty , tetralogy of fallot , restenosis , pulmonary artery , balloon , stenosis , cardiology , left pulmonary artery , surgery , cutting balloon , artery , radiology , stent , heart disease
Abstract Objectives : To evaluate the role of cutting balloon angioplasty in children with pulmonary artery stenosis. Background : Pulmonary artery stenoses can be either congenital or secondary to postoperative scar formation. Isolated multiple small‐vessel pulmonary artery stenoses are very rare. No surgical procedures for their treatment are currently available. Methods : We report on four patients in whom standard and high‐pressure balloon angioplasty had failed. Three of the four (2.5‐, 3‐, and 3.5‐years‐old; two girls) had isolated multiple peripheral pulmonary artery stenosis. The fourth patient was an 11‐month‐old girl (8 kg) with tetralogy of Fallot and hypoplastic pulmonary artery branches treated with the implantation of two stents in the pulmonary arteries. During the follow‐up this patient developed severe intrastent restenosis and showed severely hypoplasic distal left pulmonary artery. Results : We treated 11 vessels. The mean vessel diameter increased by 81% ( P < 0.0001) and RV/LV pressure ratio decreased from 1.15 to 0.75 ( P = 0.05). Patient treated for intrastent restenosis underwent successful complete tetralogy of Fallot repair. None of the patients suffered procedure‐related complications. At a median follow‐up of 18 months, results were stable and no late complications had occurred. Conclusions : Cutting balloon angioplasty is a promising technique for the treatment of highly challenging pathologies such as small vessel pulmonary artery stenoses and intrastent restenosis. © 2006 Wiley‐Liss, Inc.