At birth, pulmonary artery (PA) stenosis either can occur in isolation or can be a part of other cardiac defects or it can commonly occur after surgical repair of congenital heart disease like Tetralogy of Fallot (TOF) etc. This stenosis can occur either in main PA or can be seen in branches of pulmonary artery either right (RPA) or left (LPA) or both PA’s.
By PA stenosis, there is decreased blood supply to that side of the lung as well as associated with increase in right ventricular (RV) pressures with or without right heart failure.
Transcatheter balloon dilatation of PA stenosis (balloon angioplasty of pulmonary artery) is having a limited role as well as may be associated with various complications. Instead ballooning, stenting of PA is less problematic as well as having good outcome.
For doing this procedure, sometimes, general anesthesia is preferred over intravenous sedation.
After having an access in leg by using femoral vessels, we do angiography of affected segment to delineate the segment. Then we park a long sheath across the segment.
Then Balloon mounted stent is placed across the stenosed segment and by inflating the balloon, we placed a stent across it.
The stent position is confirmed on angiography as well as on echocardiogram.
After doing stenting of PA, there is very less chances of re-narrowing of PA, but if is there, we can dilate the stent by using a balloon instead for sending the child for surgical correction in majority of the cases.
The results of stenting of pulmonary arteries are good.