Effects of stent implantation for peripheral pulmonary artery stenosis on pulmonary vascular hemodynamics and right ventricular function in a patient with repaired tetralogy of Fallot.

Stent implantation is an effective alternative to surgery and balloon angioplasty for the treatment of stenotic vascular lesions. However, there is concern about the hemodynamic consequences related to the loss of vascular elasticity caused by the non-compliant property of the implanted stent. Here we report data for pulmonary vascular impedance and right ventricular performance after implantation of balloon-expanded stents for peripheral pulmonary stenosis in a 13-year-old girl with repaired pulmonary atresia and ventricular septal defect. Stent implantation reduced total vascular resistance, low-frequency impedance and wave reflection, and improved right ventricular contractile performance measured by the pressure-area relationship. However, pulmonary vascular wall stiffness remained elevated after stenting, and it was suggested that stent implantation resulted in a net increase in vascular wall stiffness. The long-term effects of implanted stents on vascular and ventricular hemodynamics need to be clarified.