Long-term follow-up of stents implanted to relieve peripheral pulmonary arterial stenosis: hemodynamic findings and results of lung perfusion scanning

In recent years, percutaneous placement of stents has been used as an alter native to surgery or balloon angioplasty for the treatment of adults with p eripheral pulmonary arterial stenosis. This therapy has also been proposed for children, but questions still remain about its indications in this grou p of patients. We describe here the results of intravascular placement of s tents in a group of 29 patients, with a mean age of 12+/-7 (range 3-31) yea rs and weighing 35+/-19 (range 11-74) kg. All were affected by postsurgical or congenital isolated pulmonary arterial stenosis, and have now been foll owed for 38+/-19 (range 6-65) months. The early hemodynamic results have be en excellent, with a significant reduction of the pulmonary arterial systol ic pressure, the systolic pressure gradient, and the ratio of systolic pres sures in the pulmonary and systemic circuits, and with a significant increa se of the diameter of the stented vessels in all the patients. Of the 29 pa tients, 24 have been recatheterized 18+/-10 months after the procedure, dem onstrating the stability of the results, with a low incidence of late reste nosis, this seen in only 1 patient (2%). Lung perfusion scanning, performed in 17 patients each year after the follow-up catheterization, has showed t hat the results are maintained at long-term follow-up (51+/-9 months).