INTRAVASCULAR STENTS FOR MANAGEMENT OF PULMONARY-ARTERY AND RIGHT-VENTRICULAR OUTFLOW OBSTRUCTION

This study was performed to determine the efficacy of balloon-expandab le stents in the treatment of branch pulmonary artery-stenoses and con duit stenosis in children. A total of eight stainless steel stents wer e implanted in seven patients. Three patients had tetralogy of Fallot with pulmonary artery stenosis following total correction, one patient had conduit stenosis following correction of transposition of the gre at arteries, one patient had intra-cardiac conduit stenosis after sept ation for single left ventricle, and two patients had pulmonary artery stenosis after Fontan operation. Six stents were placed in the branch pulmonary arteries, one in the extracardiac conduit, and one in the i ntracardiac conduit. The mean age at implantation was 13 +/- 3 years a nd the mean weight 37 +/- 12 kg. Follow-up time ranged from 0.3-2 year s. The diameter of pulmonary arteries with stenoses increased from 5.6 +/- 2.2 mm to 10.6 +/- 1.8 mm (n = 7). The systolic pressure gradient decreased from 56 +/- 26 mmHg to 22 +/- 16 mmHg (n = 5). No embolizat ion or thrombotic event has been noted. One stent placed in the intrac ardiac conduit was compressed and fractured. These data indicate that balloon-expandable stents are useful in the treatment of pulmonary art ery branch stenoses and extracardiac conduit stenosis in children. The use of stents for intracardiac stenosis may result in stent fracture.