Pulmonary artery stents: Long-term follow-up

Mark A. Law, Pirouz Shamszad, Alan W. Nugent, Henri Justino, John P. Breinholt, Charles E. Mullins, Frank Ing

Research output: Contribution to journalArticle

59 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)757-764
Number of pages8
JournalCatheterization and Cardiovascular Interventions
Volume75
Issue number5
DOIs
StatePublished - Apr 1 2010
Externally publishedYes

Keywords

  • Congenital heart disease
  • Pediatric intervention
  • Right ventricle

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Fingerprint Dive into the research topics of 'Pulmonary artery stents: Long-term follow-up'. Together they form a unique fingerprint.

  • Cite this

    Law, M. A., Shamszad, P., Nugent, A. W., Justino, H., Breinholt, J. P., Mullins, C. E., & Ing, F. (2010). Pulmonary artery stents: Long-term follow-up. Catheterization and Cardiovascular Interventions, 75(5), 757-764. https://doi.org/10.1002/ccd.22356