Stent Implantation in Patients with Pulmonary Arterial Stenosis

Abstract

Pulmonary arterial branch stenosis may occur congenitally or after surgical procedures. Newborns and adults with congenital heart disease may be affected. All sections of the pulmonary arterial tree may be involved: the main pulmonary artery or its origin, the central branch pulmonary arteries, and the segmental pulmonary arteries. In newborns and young infants with pulmonary arterial stenosis after surgical procedures involving the pulmonary arteries, balloon angioplasty may be employed as first-line treatment, if repeated surgery does not seem adequate. In these small patients, large stents dilatable to adult size vessel diameter cannot be implanted since large stents on large balloons need large introduction sheaths. However, balloon angioplasty may not always lead to an acceptable flow increase of the stenotic lung segment and even in this difficult patient group stent implantation may be the only solution. In general, stent implantation is the preferred first-line treatment in patients with pulmonary arterial stenosis, in whom a stent can be implanted, which can be expanded to an adult size diameter though.