Journal of Clinical Pediatrics ›› 2020, Vol. 38 ›› Issue (7): 497-.doi: 10.3969/j.issn.1000-3606.2020.07.005

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Therapeutic effect of percutaneous intervention on pulmonary artery branch stenosis in children

 SUN Chunping2, ZHANG Zhiwei1, XIE Yumei1, LI Junjie1, XIE Zhaofeng1, QIAN Mingyang1   

  1. 1.Guangdong Cardiovascular Institute, Guangdong Province People’s Hospital, Guangdong Academy of Medical Science, Department of Pediatric Cardiology, Guangzhou 510100, Guangdong, China; 2.Department of Cardiovascular Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
  • Published:2020-07-14

Abstract:  Objective To explore the safety and effectiveness of percutaneous intervention for pulmonary artery branch stenosis in children. Methods The clinical data of pulmonary artery branch stenosis in 40 children under 18 years old who were diagnosed and received percutaneous intervention from January 2012 to December 2017 were retrospectively analyzed and the conditions before and after treatment were compared. Results In the 40 children (28 males and 12 females) with a median age of 3.5 years (2.0 - 6.8 years), percutaneous balloon angioplasty was performed in 6 cases and covered stent implantation was performed in 32 cases. After stent implantation or balloon angioplasty, the difference in systolic blood pressure was significantly decreased, the minimum diameter of the stenosis segment was significantly increased, and the right ventricular systolic blood pressure was significantly decreased. The differences were statistically significant (all P<0.05). The median follow-up time was 22 months (range 1 - 60 months) and there was no evidence of arterial dissection, aneurysm formation, stent rupture or displacement in 34 patients with stent implantation. The cross-stent differential pressure by echocardiography was 16.50 (9.75-25.50) mmHg immediately after operation and was 23.5 (16.8 - 34.0) mmHg during follow-up. The difference was statistically significant (Z=4.02, P<0.001). The median follow-up time was 13 months (range 1 - 36 months) in 6 children with balloon angioplasty. The cross-stent differential pressure by echocardiography was 33.0 (15.5 - 45.5) mmHg immediately after operation and was 36.0 (16.0- 58.5) mmHg during follow-up. The difference was not statistically significant (Z=1.83, P=0.068). There were no serious adverse events in all children. Conclusion Both percutaneous stent implantation and balloon angioplasty are effective and safe in the treatment of pulmonary artery stenosis in children.

Key words:  pulmonary artery branch stenosis; balloon angioplasty; stent; child