One center experience in pulmonary artery stenting without long vascular sheath

Cardiol J. 2010;17(2):149-56.

Abstract

Background: Pulmonary artery stenting without a long vascular sheath has a special significance, particularly for children with low body weight. Using only a short sheath often permits the implantion of a stent of the correct size; moreover, it improves access to peripherally located stenoses. The aim of this paper is to present the results of a balloon expandable stent implantation into pulmonary arteries without using a long vascular sheath.

Methods: The subjects were divided into two groups. The first group (28 patients, mean age 3.2 years) comprised patients with a single-ventricle heart after bi-directional Glenn procedure (Fontan procedure). The second group (22 patients, mean age 8.3 years) consisted of patients with a two-ventricle heart. Patients were retrospectively analyzed with regard to stenosis size widening and change in trans-stenotic pressure gradient after stenting.

Results: In our data, no statistically significant differences between the two groups in terms of the number of complications and incorrect stent position following implantation were noted (3% and 4%). Good treatment results, with a decrease in trans-stenotic pressure gradient in the first group of 3.2 mm and in the second group of 13.4 mm of mercury, and a widening of the stenosis, were obtained in most cases in both groups (97% and 96%). The average change of the vessel's diameter was in the first group 4.2 mm and in the second 5.4 mm.

Conclusions: The obtained results suggest that pulmonary artery stenting with a short vascular sheath has numerous advantages and can be successfully performed in children. In the case of single-ventricle hearts after a Glenn procedure, it may indeed be the method of choice.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Angioplasty, Balloon / adverse effects
  • Angioplasty, Balloon / instrumentation*
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / physiopathology
  • Arterial Occlusive Diseases / therapy*
  • Blood Pressure
  • Child
  • Child, Preschool
  • Constriction, Pathologic
  • Equipment Design
  • Humans
  • Infant
  • Poland
  • Prosthesis Design
  • Pulmonary Artery* / diagnostic imaging
  • Pulmonary Artery* / physiopathology
  • Radiography
  • Retrospective Studies
  • Stents*
  • Treatment Outcome
  • Young Adult