Mujeeb A Sheikh, Mohammed A Chowdhury, George V Moukarbel1. 1. Division of Cardiovascular Medicine, The University of Toledo Medical Center, 3000 Arlington Avenue, Toledo, OH 43614 USA. george.moukarbel@utoledo.edu.
Abstract
BACKGROUND: Pulmonary artery stenosis (PAS) in adults is a rare condition. The role of endovascular stent implantation as a therapeutic option has not been clearly defined. METHODS AND RESULTS: We performed a retrospective review of all cases of adult-onset PAS published in Pubmed/Medline from 1990 to 2013. A total of 126 cases of adult-onset PAS were identified, out of which 46 cases (37%) were treated with an endovascular intervention. Symptomatic improvement was reported in 98% of cases. Average translesional gradient at baseline was 47 ± 20 mm Hg, which reduced to 8 ± 11 mm Hg after stenting (P<.001). Mean preprocedural pulmonary systolic artery pressures were 79 ± 26 mm Hg, which reduced post procedure to 50 ± 20 mm Hg (P=.02). There were no immediate adverse events reported related to procedure. In-stent restenosis was reported in 7 cases on follow-up. CONCLUSION: Endovascular treatment appears safe and effective for symptom relief in adult-onset PAS and should be considered as an alternative treatment option in patients with prohibitive surgical risk.
BACKGROUND:Pulmonary artery stenosis (PAS) in adults is a rare condition. The role of endovascular stent implantation as a therapeutic option has not been clearly defined. METHODS AND RESULTS: We performed a retrospective review of all cases of adult-onset PAS published in Pubmed/Medline from 1990 to 2013. A total of 126 cases of adult-onset PAS were identified, out of which 46 cases (37%) were treated with an endovascular intervention. Symptomatic improvement was reported in 98% of cases. Average translesional gradient at baseline was 47 ± 20 mm Hg, which reduced to 8 ± 11 mm Hg after stenting (P<.001). Mean preprocedural pulmonary systolic artery pressures were 79 ± 26 mm Hg, which reduced post procedure to 50 ± 20 mm Hg (P=.02). There were no immediate adverse events reported related to procedure. In-stent restenosis was reported in 7 cases on follow-up. CONCLUSION: Endovascular treatment appears safe and effective for symptom relief in adult-onset PAS and should be considered as an alternative treatment option in patients with prohibitive surgical risk.