| Experience of Stent Implantation in Branch Pulmonary Artery Stenosis of the Congenital Heart Diseas |
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Yong Soo Yun, Eun Jung Cheon, Ho Sung Kim, Chung Il Noh, Jung Yun Choi |
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Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea |
| 선천성 심질환에 병발된 분지 폐동맥 협착에서 Stents삽입 효과 |
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윤용수, 천은정, 김호성, 노정일, 최정연 |
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서울대학교 의과대학 소아과학교실 |
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| Abstract |
Purpose
: Branch pulmonary artery stenosis remains a clinically challenging lesion.
Results
of surgical angioplasty are rarely rewarding, and balloon angioplasty is not
uniformly successful. So, endovascular stent has been applied recently to these lesions.
But this new modality has not been full yevaluated. The aim of this study is to evaluate
the short-term result of stent implantation in postoperative branch pulmonary artery
stenosis.
Methods
: In selected 17 children with postoperative branch pulmonary artery stenosis,
balloon-expandable stent implantation were attempted between Aug.1993 and Feb.1996.
They all had Tetralogy of Fallot except one with ventricular septal defect and pulmonary
atresia and had been underwent total correction. For assessment of results of stent
implantation,intraluminal diameter ratio(LPA/RPA) and pressure gradient across the
narrowest point were measured, and radionuclide lung perfusion scan was done before
and after the procedure.
Results
: Fifteen stents were successfully implanted in each 15 children, aged 3.4
years to 12.7 years. The average ratio of vesseldiameter (LPA/RPA) on angiogam
increased from 0.49¡¾0.15 to 0.96¡¾0.18, pulmonary perfusion fraction from 25.6¡¾6.1 to
38.9¡¾9.9% and pressure gradients from 19.0¡¾8.5mmHg to 7.4¡¾6.0mmHg with stent
placement. All changes were statistically significant. There were no fever,transfusion
requirement, femoral artery thrombosis, and transient bradycardia during the procedure.
Implantation failure was two cases. Failure was due to displacement of stent to distal
pulmonary artery.
Conclusion
: Success rate of stent implantation is 88%. Effective relief of stenosis is accomplished in 93%. Stent implantation is effective and safe modality for postoperative branch pulmonary artery stenosis in short-term follow-up. |
| Key Words:
Branch pulmonary artery stenosis, Stent, Tetralogy of Fallot |
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