Comparison of conventional and cutting balloon angioplasty for congenital and postoperative pulmonary vein stenosis in infants and young children

Lynn F. Peng, James E. Lock, Alan W. Nugent, Kathy J. Jenkins, Doff B. McElhinney

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background: Pulmonary vein stenosis (PVS) is a rare and often lethal condition in children. The optimal treatment for congenital and postoperative PVS is unknown. Methods and Results: We compared outcomes of conventional balloon angioplasty performed for PVS from 1999 to 2003 against cutting balloon angioplasty performed from 2004 to 2007. A total of 100 previously undilated pulmonary veins in 54 patients were studied: 48 veins dilated with conventional balloons and 52 with cutting balloons. Acute results included significantly reduced gradients and increased lumen diameters with both treatments. Acutely, cutting balloon angioplasty and conventional angioplasty yielded similar relative reduction of the PVS gradient (median 78% vs. 63%, P = 0.08) and increase in lumen diameter (median 77% vs. 59%, P = 0.07). There was one procedural death of a critically ill infant, and four cardiac arrests, but no adverse events necessitating surgical intervention. Survival free from reintervention was poor in both groups, and shorter in the cutting balloon group (73% at 1 month, 11% at 6 months, and 4% at 1 year) than in the conventional angioplasty group (77% at 1 month, 35% at 6 months, and 23% at 1 year; P = 0.01). Conclusions: Both conventional and cutting balloon angioplasty were effective at decreasing gradient and increasing lumen size acutely in patients with congenital and postoperative PVS, but reintervention was common with both treatments. Both methods of angioplasty provided limited benefit, and neither was curative for this complex disease.

Original languageEnglish (US)
Pages (from-to)1084-1090
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume75
Issue number7
DOIs
StatePublished - Jun 1 2010

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Balloon Angioplasty
Angioplasty
Pulmonary Veins
Heart Arrest
Critical Illness
Veins
Therapeutics
Pulmonary Vein Stenosis
Survival

Keywords

  • Congenital pulmonary vein stenosis
  • Cutting balloon angioplasty
  • Postoperative pulmonary vein stenosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Comparison of conventional and cutting balloon angioplasty for congenital and postoperative pulmonary vein stenosis in infants and young children. / Peng, Lynn F.; Lock, James E.; Nugent, Alan W.; Jenkins, Kathy J.; McElhinney, Doff B.

In: Catheterization and Cardiovascular Interventions, Vol. 75, No. 7, 01.06.2010, p. 1084-1090.

Research output: Contribution to journalArticle

Peng, Lynn F. ; Lock, James E. ; Nugent, Alan W. ; Jenkins, Kathy J. ; McElhinney, Doff B. / Comparison of conventional and cutting balloon angioplasty for congenital and postoperative pulmonary vein stenosis in infants and young children. In: Catheterization and Cardiovascular Interventions. 2010 ; Vol. 75, No. 7. pp. 1084-1090.
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