921-73 Stent Implantation for Relief of Branch Pulmonary Artery Stenosis: Immediate and Short-term Results
| Autor: | Omar Galal, Robert L. Geggel, Gerald R. Marx, Michiel deMoor, Fadel Fadley, Ziyad M. Hijazi |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
medicine.medical_specialty
Pulmonary artery stenosis business.industry medicine.medical_treatment Stent Balloon medicine.disease Inferior vena cava Surgery Stenosis medicine.vein Restenosis Angioplasty medicine cardiovascular diseases Radiology Cardiology and Cardiovascular Medicine business Cardiac catheterization |
| Zdroj: | Journal of the American College of Cardiology. 25:100A |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/0735-1097(95)91868-x |
| Popis: | Stent implantation to relieve branch pulmonary artery stenosis (BPAS) is an alternative to failed surgical or balloon angioplasty. From April 1992 to August 1994, 26 patients underwent an attempt at stent implantation (11 in Boston; group 1 and 15 in Riyadh; group 2). The two groups median age was 7.6 years (range 1.3 – 64 years). 20/26 were post surgical repair of tetralogy of Fallot, two patients after Fontan operation, two with native BPAS, and one each with Williams syndrome and Alagille syndrome. A total of 37 stents were implanted successfully in 25 patients (16 in group 1 and 21 in group 2). The systolic gradient across the stenosis fell from a median of 40 ± 22 to 9 ± 6 mmHg, p l 0.001 and the diameter of the narrowest segment improved from 4.7 ± 0.4 to 10.8 ± 0.4 mm, p l 0.001. The right ventricle to aortic pressure ratio fell from 0.68 to 0.49, P l 0.001. The median fluoroscopy time was 150 ± 20 minutes. Complications included 2 patients where the balloon ruptured prior to full stent inflation, one stent was positioned in the superior vena cava and the other in the inferior vena cava. No other complications. Quantitative lung perfusion scan was performed pre and post stent deployment in 9 patients. This showed significant improvement of pulmonary blood flow in patients receiving unilateral stent. Patients were maintained on aspirin alone in group 1 and aspirin with dipyridamole in group 2. 10 patients underwent repeat cardiac catheterization at a mean follow-up interval of 15 months. The gradient across the stent remained low at 20 ± 4 mmHg and there was no change in the diameter (11 ± 0.5 mm). One patient developed significant restenosis secondary to intimal proliferation at the stent site, this was redilated successfully. We conclude that balloon expandable stents are safe and effective in relieving BPAS. Stents should be considered the treatment of choice for most patients with BPAS. |
| Databáze: | OpenAIRE |
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