The Application Of Stent In The Residual Branch Pulmonary Artery Stenosis After Treatment Of Complex Congenital Heart Disease

Objective: To explore the indication,methods and effect of using balloon expandable stent placement to treat residual branch pulmonary artery stenosis.Methods: Seven cases with residual branch pulmonary artery stenosis after therapy treatment of congenital heart disease underwent the balloon expandable stent placement.The age was 4 to 18years(8.7±6.3years).The weight was 13 to 56kg(28.4±17.3kg).Results: Six cases of residual branch pulmonary artery stenosis from the therapy treatment of TOF received the implantation of Pul-stent in the left pulmonary artery and right pulmonary artery respectively.And one case of left pulmonary stenosis from the therapy treatment of corrected transposition of great arteries received the implantation of Pul-stent in the left pulmonary artery.Early follow up: The mean minimum diameter of left and right pulmonary arteries increased from(4.1±1.0)mm to(10.9±2.7)mm.The mean pressure gradient around the stenosis region decreased from(62.0±12.0mm Hg)to(34.9±16.8mm Hg).Midterm follow up: The mean minimum diameter of left and right pulmonary arteries increased from(4.1±1.0)mm to(10.1±2.1)mm.The mean pressure gradient around the stenosis region decreased from(62.0±12.0mm Hg)to(29.6±12.7mm Hg).The TAPSE increased from(12.4±3.5)mm to(18.6±5.1)mm.The myocardial contraction velocity of right ventricle increased from(7.6±1.8)cm/s to(11.2±3.9)cm/s.And the e' increased from(4.8±2.0)cm/s to(10.6±3.5)cm/s.After the surgery,the daily movement of patients increased obviously.The diameter of stenosis region increased obviously.There was no complication such as restenosis,embolism and endocarditis or stents translocation and break.Conclusion: After the implantation of Pul-stent in the branch pulmonary,the daily movement of patients increased obviously.The mean pressure gradient around the stenosis region decreased.And the function of right ventricle has improved.The balloon expandable stent placement is a great therapeutic method for the branch pulmonary artery stenosis.