| Pulmonary artery stents: long-term follow-up. | |
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MedLine Citation:
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PMID: 20146310 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Determine the long-term outcomes of branch pulmonary artery (PA) stents. BACKGROUND: PA stents in congenital heart disease effectively relieve stenoses in the short-term. Published long-term data are limited. METHODS: Patients enrolled in an FDA IDE protocol from 1989-92 were included. Clinical follow-up and catheterization data were evaluated. Patients were included if >5 year follow-up data was available or if mortality occurred following the initial procedure. RESULTS: There were five deaths: four due to progression of their underlying heart disease, and one from a complication during a follow-up catheterization. Clinical data for 43 surviving patients demonstrated 39 patients (91%) are in NYHA class I or II. Seven patients underwent surgical intervention during the follow-up period (five RV-PA conduit, two Fontan revisions), but none addressed PA stenosis. Final repeat catheterizations were performed in 36 patients (55 stents) 7.2 +/- 4.3 years post stent insertion with 1.2 +/- 0.9 further procedures with stent dilations. In this subgroup, the minimum vessel diameter increased from 4.7 +/- 1.8 to 13.4 +/- 2.4 mm (P < 0.001), and the pressure gradient improved from 41 +/- 25 to 9 +/- 11 mm Hg (P < 0.001). Higher initial gradient and smaller balloons were associated with a final stent diameter of <14 mm (P = 0.030 and 0.046). Jailed vessels occurred in 49% of stents with abnormal angiographic flow in 18/55. Six repeat catheterizations resulted in complications, including the one procedural death. CONCLUSION: Stents implants for PA stenoses provide effective improvement in vessel caliber in the long-term. Although repeat interventions are necessary, this procedure reduces RV pressure and provides an important alternative to surgery for residual PA obstruction. |
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Authors:
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Mark A Law; Pirouz Shamszad; Alan W Nugent; Henri Justino; John P Breinholt; Charles E Mullins; Frank F Ing |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 75 ISSN: 1522-726X ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-03-30 Completed Date: 2010-06-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 757-64 Citation Subset: IM |
Copyright Information:
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(c) 2009 Wiley-Liss, Inc. |
Affiliation:
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Department of Pediatric Cardiology, University of Alabama at Birmingham, Birmingham, Alabama, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Angioplasty, Balloon / adverse effects, instrumentation*, mortality Arterial Occlusive Diseases / diagnosis, mortality, physiopathology, therapy* Cardiac Surgical Procedures Child Child, Preschool Constriction, Pathologic Female Follow-Up Studies Heart Defects, Congenital / diagnosis, mortality, physiopathology, therapy* Hemodynamics Humans Male Prosthesis Design Prosthesis Failure Pulmonary Artery* / growth & development, physiopathology, radiography, ultrasonography Recovery of Function Stents* Time Factors Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Catheter Cardiovasc Interv. 2010 Apr 1;75(5):765-6
[PMID:
20333772
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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