Pulmonary vein stenosis: Initial experience with cutting balloon angioplasty

Anna N Seale ¹, Piers E F Daubeney ^1*, Alan G Magee ¹ and Michael L Rigby ¹

¹ The Royal Brompton Hospital, United Kingdom

^* To whom correspondence should be addressed. E-mail: p.daubeney{at}rbht.nhs.uk.

Accepted 26 October 2005

Abstract

Objective: To determine the safety and efficacy of cutting balloon angioplasty for pulmonary vein stenosis (PVS).

Design and setting: Retrospective review of case notes and cardiac catheterisation data at the Royal Brompton Hospital.

Main outcome measures: Diameter of pulmonary vein, tricuspid regurgitant jet velocity on echocardiogram, and percutaneous oxygen saturation, before and after cutting balloon angioplasty.

Results: Three patients had congenital PVS and three had PVS associated with total anomalous pulmonary venous drainage. A total of 27 pulmonary vein stenoses were treated during 12 catheterisation procedures. Median patient age at the time of procedure was 12.5 months (range: 1.5 to 36 months) and weight was 7.1kg (2.8 - 11.1kg). There was a significant increase in minimum pulmonary vein diameter on angiography following cutting balloon angioplasty, from 2.3mm (SD 0.7mm) to 4.2mm (SD 1.9mm), mean of differences 1.9mm (95% CI 0.9 - 2.9mm) (p=0.0013). Mean oxygen saturation rose from 79.6% (SD 12.9%) to 83.9% (SD 9.0%), mean of differences 4.3% (95% CI 0.7 to 8.0%) (p=0.0238). There was a subjective improvement in symptoms in all children. There was no significant change in the tricuspid regurgitant jet velocity. The longest time interval before repeat intervention was six months. There were no acute deaths; one patient had a small pulmonary haemorrhage and developed a small aneurysm adjacent to the site of angioplasty.

Conclusion: Cutting balloon angioplasty is safe in the palliation of PVS in children. It gives some acute relief but often needs to be repeated as improvement is rarely sustained.

Keywords: pulmonary vein stenosis, cutting balloon

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Seale, A N, Webber, S A, Uemura, H, Partridge, J, Roughton, M, Ho, S Y, McCarthy, K P, Jones, S, Shaughnessy, L, Sunnegardh, J, Hanseus, K, Rigby, M L, Keeton, B R, Daubeney, P E F, on behalf of the British Congenital Cardiac Associ, (2009). Pulmonary vein stenosis: the UK, Ireland and Sweden collaborative study. Heart 95: 1944-1949 [Abstract] [Full Text]  
• Drossner, D. M., Kim, D. W., Maher, K. O., Mahle, W. T. (2008). Pulmonary Vein Stenosis: Prematurity and Associated Conditions. Pediatrics 122: e656-e661 [Abstract] [Full Text]  
• Latson, L. A., Prieto, L. R. (2007). Congenital and Acquired Pulmonary Vein Stenosis. Circulation 115: 103-108 [Full Text]