Hideshi Tomita, Ken Watanabe, Satoshi Yazaki, Kohji Kimura, Yasuo Ono, Toshikatsu Yagihara, Shigeyuki Echigo
National Cardiovascular Center.
Japan
Circulation Journal
Circ J 2003; 67: 187-190
DOI: 10.1253/circj.67.187
Abstract
The outcome of stent implantation and redilatation was investigated in 4 pediatric patients with 7 stenotic lesions of the pulmonary vein (PV), paying particular attention to late neointimal proliferation. The minimal diameter of the lesions increased from 0.8-3.6 (2.3+/-1.1) mm to 3.6-8.4 (5.1+/-1.6) mm immediately after stent implantation. Although the pressure gradient across the lesion was not measured in patient 4, in patients 1-3, it decreased from 4-34 (18+/-13) mmHg to 3-15 (7+/-4) mmHg. Except for case 4, who achieved a lesion diameter of 8.4 mm after initial stent dilatation, the other 6 lesions all restenosed within a few months, with an increasing pressure gradient. One patient with multiple PV stenoses associated with persistent severe pulmonary hypertension died suddenly. However, repeat dilatations were effective in all other lesions. Furthermore, in one lesion in patient 1, no serious restenosis developed for 20 months after the lesion was dilated up to 5.6 mm. Although further follow-up is mandatory, the final stent diameter within a vessel may determine long-term patency, and aggressive redilatation may be crucial for successful therapy of such a difficult disease.
Category
Stenosis or Obstruction of Normal Pulmonary Venous Connections
Stenosis or Obstruction of Pulmonary Veins Following Surgical Repair of Anomalous Pulmonary Venous Connections
Pulmonary Hypertension Associated with Stenosis or Atresia of Pulmonary Veins
Catheter-mediated Interventions: Efficacy or Lack of Efficacy
Year of Publication: 2003
Age Focus: Pediatric
Article Type: Retrospective Clinical Observations in Large Groups of Patients
Article Access: Free PDF File or Full Text Article Available Through PubMed or DOI: Yes