Medium and Long-Term Outcomes After Bilateral Pulmonary Artery Stenting in Children and Adults With Congenital Heart Disease

Abstract

Percutaneous stenting of branch pulmonary arteries (PAs) has become an important interventional therapy in the complete management of congenital heart disease. Few data exist on long-term outcomes for patients requiring placement of bilateral stents. This study aimed to determine the medium- to long-term outcomes after bilateral stenting of branch PAs in patients with congenital heart disease. A retrospective study analyzed all procedural and follow-up data on patients undergoing bilateral PA stenting during a single procedure. From October 2001 to May 2012, 26 patients underwent bilateral PA stenting (total of 62 stents). The mean age of these patients was 9.5 ± 12 years, and their mean weight was 27 ± 19 kg. The mean procedural time was 191 ± 67 min, and the mean fluoroscopy time was 50 ± 29 min. The mean gradient across the right pulmonary artery decreased from 35 ± 22 to 11 ± 12 mmHg (p < 0.001). The left pulmonary artery gradient decreased from 32 ± 17 to 10 ± 12 mmHg (p < 0.001), and the right ventricle to descending aorta pressure ratio decreased from 71 ± 18 % to 46 ± 13 % (p < 0.001). Intraprocedural adverse events were encountered in four patients (1 small PA dissection, 2 intraprocedural arrhythmias, and 1 first-degree burn on the thigh). The mean follow-up period was 41 ± 23 months. Two deaths occurred. Further interventions were required for 12 patients. Bilateral PA stenting is effective and safe, with an instantaneous significant decrease in pressure gradients. The need for reintervention is common, so continued follow-up assessment is warranted.