Pulmonary artery branch stenosis in patients with congenital heart disease

Vladimiro L. Vida, Mauro Lo Rito, Fabio Zucchetta, Roberta Biffanti, Massimo A. Padalino, Ornella Milanesi, Giovanni Stellin

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Abstract

Objective We sought to evaluate our recent experience with surgical treatment of branch pulmonary artery (PA) stenosis both for native and acquired lesions. Materials and Methods The postoperative course of patients who underwent surgical PA plasty augmentation between January 2004 and January 2012 were reviewed. Primary outcomes included the need for further surgical procedures or interventional maneuvers on the branch PAs for residual stenosis. Results Thirty-four patients were included. Median age at PA plasty was eight months (range 8 days to 3.4 years). There were 12 native and 22 acquired PA stenoses, which were mainly located at the PA branch origin (n = 25, 73%). The PA plasty was defined as simple (n = 16, 47%) and as complex (n = 18, 53%), which included multiple maneuvers on the PA branches. Median follow-up time after surgical treatment was 4.7 years (range 0.9 to 8.7 years). One patient died 3 days after complex PA plasty for low output syndrome and another died 22 months later for congestive heart failure. Twenty-one (63.6%) underwent 40 catheter intervention procedures on the PA branches for residual stenosis. The majority of them (n = 10, 57.1%) were operated before the age of six months and the majority had an acquired PA stenosis (14, 66.7%). Three patients underwent additional surgical maneuvers on the PA branches. Conclusions PA branch stenosis represents a life-threatening condition often necessitating further surgical or interventional treatment. A combined collaborative surgical followed by transcatheter approach is important, particularly in cases with an acquired PA stenosis who require complex surgical repair. doi: 10.1111/jocs.12121 (J Card Surg 2013;28:439-445)

Original languageEnglish
Pages (from-to)439-445
Number of pages7
JournalJournal of Cardiac Surgery
Volume28
Issue number4
DOIs
Publication statusPublished - Jul 2013

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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    Vida, V. L., Rito, M. L., Zucchetta, F., Biffanti, R., Padalino, M. A., Milanesi, O., & Stellin, G. (2013). Pulmonary artery branch stenosis in patients with congenital heart disease. Journal of Cardiac Surgery, 28(4), 439-445. https://doi.org/10.1111/jocs.12121