TY - JOUR
T1 - Pulmonary vein rehabilitation
AU - Aljohani, Othman A.
AU - Mackie, Duncan
AU - Frazer, Jeffrey
AU - You, Hyeri
AU - Nageotte, Stephen J.
AU - Ratnayaka, Kanishka
AU - Moore, John W.
AU - El-Said, Howaida G.
N1 - Funding Information:
The Altman Clinical and Translational Research Institute (CTRI) at UC San Diego provided statistical support. CTRI is partially supported by the National Institutes of Health (NIH), Grant UL1TR001442 of CTSA funding. The content of this work is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Funding Information:
The Altman Clinical and Translational Research Institute (CTRI) at UC San Diego provided statistical support. CTRI is partially supported by the National Institutes of Health (NIH), Grant UL1TR001442 of CTSA funding. The content of this work is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2021/3
Y1 - 2021/3
N2 - Pulmonary vein stenosis (PVS) in children is a progressive disease with poor outcomes. Surgical and catheter-based interventions can provide immediate relief of stenosis, but re-stenosis is common, often progressive, and can be fatal. We pursued serial balloon angioplasty (BA) to treat patients with recurrent PVS at our center. We performed a retrospective chart review and data analysis of all children (age < 18 years) with PVS treated with BA at a single center over ten years (2008–2017). Balloon angioplasties (n = 278) were performed on 69 stenotic pulmonary veins in 23 patients during 150 catheterization procedures. The median number of BA was 3 per pulmonary vein (IQR 2–7, range 1–20) and the median number of catheterization procedures was 5 per patient (IQR 2–9, range 2–23). The median age of the first BA was 4.7 months (IQR 2.9–13.8, range 2–65.3). The median follow-up duration was 2.6 years (IQR 1.4–7.1, range 0.42–9.6). 17 veins were stented with 18 stents (15 bare-metal and 3 drug-eluting). There were no procedural deaths or adverse outcomes requiring surgical intervention. 26 veins underwent subsequent planned surgical revision. The 1-, 3-, and 5-year survival rates (from first BA) were 78%, 70%, and 70%, respectively. In conclusion, for children with PVS, serial balloon angioplasty as a bridge to resolution, stenting, or surgical repair resulted in favorable outcomes. Further prospective studies comparing the outcomes of different treatment strategies are needed.
AB - Pulmonary vein stenosis (PVS) in children is a progressive disease with poor outcomes. Surgical and catheter-based interventions can provide immediate relief of stenosis, but re-stenosis is common, often progressive, and can be fatal. We pursued serial balloon angioplasty (BA) to treat patients with recurrent PVS at our center. We performed a retrospective chart review and data analysis of all children (age < 18 years) with PVS treated with BA at a single center over ten years (2008–2017). Balloon angioplasties (n = 278) were performed on 69 stenotic pulmonary veins in 23 patients during 150 catheterization procedures. The median number of BA was 3 per pulmonary vein (IQR 2–7, range 1–20) and the median number of catheterization procedures was 5 per patient (IQR 2–9, range 2–23). The median age of the first BA was 4.7 months (IQR 2.9–13.8, range 2–65.3). The median follow-up duration was 2.6 years (IQR 1.4–7.1, range 0.42–9.6). 17 veins were stented with 18 stents (15 bare-metal and 3 drug-eluting). There were no procedural deaths or adverse outcomes requiring surgical intervention. 26 veins underwent subsequent planned surgical revision. The 1-, 3-, and 5-year survival rates (from first BA) were 78%, 70%, and 70%, respectively. In conclusion, for children with PVS, serial balloon angioplasty as a bridge to resolution, stenting, or surgical repair resulted in favorable outcomes. Further prospective studies comparing the outcomes of different treatment strategies are needed.
KW - Congenital heart disease
KW - Pulmonary vein stenosis
KW - Serial balloon angioplasty
KW - Total anomalous pulmonary venous connection
UR - http://www.scopus.com/inward/record.url?scp=85088808095&partnerID=8YFLogxK
U2 - 10.1016/j.ppedcard.2020.101277
DO - 10.1016/j.ppedcard.2020.101277
M3 - Review article
AN - SCOPUS:85088808095
SN - 1058-9813
VL - 60
JO - Progress in Pediatric Cardiology
JF - Progress in Pediatric Cardiology
M1 - 101277
ER -