Simultaneous stent implantation to treat bifurcation stenoses in the pulmonary arteries: Initial results and long-term follow up

Gary E. Stapleton, Rabih Hamzeh, Charles E. Mullins, Thomas M. Zellers, Henri Justino, Alan Nugent, Michael R. Nihill, Ronald G. Grifka, Frank F. Ing

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)557-563
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume73
Issue number4
DOIs
StatePublished - Mar 1 2009

Keywords

  • Bifurcating stents
  • Cardiac catheterization
  • Pulmonary artery stenoses

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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