Relief of Proximal Left Pulmonary Artery Branch Stenosis Using a Self-Expandable Stent following Tetralogy of Fallot Repair.

Proximal pulmonary artery (PA) stenosis is frequently observed following surgery for congenital heart disease, especially in cases of tetralogy of Fallot (TOF), and is one of the most common indications for reoperation. However, limited information is available regarding the efficacy of self-expandable stent implantation for proximal branch PA stenosis after total corrective surgery of TOF.Self-expandable stent placement was performed in 8 patients with left proximal PA stenosis from August, 2016 to August, 2020. The patients were mostly women (75%), with a median weight of 55.8 kg (range, 44-72 kg) and a median height of 159.15 cm (range, 150-183 cm).The narrowest mean diameter of the left PA was 7.72 ± 2.0 mm (range, 5.15-10.86 mm). The mean diameter of the stent was 16.25 ± 0.7 mm (range, 16-18 mm), and the mean stent length was 37.5 ± 4.6 mm (range, 30-40 mm). After stenting, the narrowest mean diameter of the left PA was 12.54 ± 2.23 mm (range, 8.21-14.8 mm) (P < 0.05). The mean pressure gradient across the stenotic lesion decreased from 12 ± 4.95 mmHg (range, 3-18 mmHg) to 1.38 ± 0.99 mmHg (range, 0-3 mmHg) (P < 0.05). At follow-up, all implanted stents remained in their original position. Evidence of fracture, restenosis within the stents, or other related complications did not occur.Branch pulmonary stenosis is a critical condition that often requires further surgical or interventional treatment. Our findings demonstrated that the use of self-expandable stents for the treatment of proximal PA stenosis is safe and effective.