Simultaneous stent implantation to treat bifurcation stenoses in the pulmonary arteries: Initial results and long-term follow up
| Autor: | Frank F. Ing, Michael R. Nihill, Henri Justino, Gary E. Stapleton, Alan Nugent, Ronald G. Grifka, Thomas M. Zellers, Rabih Hamzeh, Charles E. Mullins |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent medicine.medical_treatment Arterial Occlusive Diseases Blood Pressure Constriction Pathologic Pulmonary Artery Radiography Interventional Balloon Constriction Young Adult Angioplasty medicine.artery Ventricular Pressure medicine Humans Radiology Nuclear Medicine and imaging Child Retrospective Studies Cardiac catheterization business.industry Infant Stent General Medicine medicine.disease United States Surgery Treatment Outcome Blood pressure Child Preschool Pulmonary artery Ventricular Function Right Female Stents Pulmonary hemorrhage Cardiology and Cardiovascular Medicine business Angioplasty Balloon |
| Zdroj: | Catheterization and Cardiovascular Interventions. 73:557-563 |
| ISSN: | 1522-726X 1522-1946 |
| Popis: | Background: Balloon angioplasty of bifurcating pulmonary artery (PA) stenoses is often inadequate, and stent treatment often requires simultaneous implantation of two stents. This study evaluates initial results and long-term follow up of transcatheter stent placement in bifurcating PAs. Methods: This is a retrospective review of patients (pts) who had bifurcating PA stents placed in main and lobar branches from 1993 to 2007. Results: Forty-nine pts had bifurcating PA stents placed at a median age of 10.9 years (range 1–43 years). The mean minimum vessel diameter increased from 5.7 ± 2.5 mm to 11.0 ± 3.6 mm (P < 0.001), the mean gradient across the stenoses decreased from 37.0 ± 26.9 to 9.2 ± 13 mm Hg (P < 0.001), whereas the mean RV:FA ratio decreased from 0.76 ± 0.29 to 0.53 ± 0.24 (P < 0.001). There was one death due to severe pulmonary hemorrhage. F/U data were available in 38 pts (mean duration 6.3 ± 4.1 years, range 1.2–13.1 years). Thirty pts underwent repeat catheterizations (mean 2.3 ± 2.2 years poststent), with 26 requiring further interventions: Fifteen had balloon angioplasty alone and 11 had additional stents placed. There were no complications at f/u catheterization. Six pts underwent further palliative surgeries, although none for repair of branch PA stenoses. Conclusions: Simultaneous transcatheter placement of bifurcating PA stents provides immediate gradient relief of bifurcating stenoses in the proximal or lobar branch PAs and reduces RV systolic pressure. Further interventions can be safely performed in future procedures, and the presence of stents does not complicate future surgeries. © 2009 Wiley-Liss, Inc. |
| Databáze: | OpenAIRE |
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