TY  - EJOU
AU  - Li, Yifan 
AU  - Huang, Xu 
AU  - Ma, Bingyu 
AU  - Sun, Ling 
AU  - Wang, Shushui 
AU  - Zhang, Zhiwei 
AU  - Xie, Yumei 

TI  - Long-Term Follow-Up of Percutaneous Stent Implantation for Residual Pulmonary Artery Stenosis in Pediatric Patients after Surgical Repair of Complicated Congenital Heart Diseases
T2  - Structural and Congenital Heart Disease

PY  - 2025
VL  - 20
IS  - 4
SN  - 3071-1738

AB  - <b>Objective:</b> The aim of the present study was to investigate long-term efficacy and safety of percutaneous stent implantation for residual pulmonary artery stenosis (PAS) in pediatric patients after surgical repair of complicated congenital heart diseases (CHDs). <b>Methods:</b> All pediatric patients diagnosed with residual PAS after surgical repair of complicated CHDs between 1996 and 2020 were retrospectively enrolled in the study. <b>Results:</b> A total of 41 patients (30 males, 11 females; median age 5.0 years, median weight 17 kg) were followed-up for a median of 7.1 years. Follow-up echocardiography results demonstrated that the target vessel diameter increased from (3.4 ± 1.1) mm preoperatively to (6.2 ± 1.9) mm one year post-procedure and (6.0 ± 1.5) mm at the final follow-up (<i>p</i> < 0.05). The pressure gradient across the stenosis decreased from (52.6 ± 15.8) mmHg preoperatively to (35.8 ± 19.1) mmHg one year post-procedure and (33.1 ± 19.7) mmHg at the final follow-up (<i>p</i> < 0.05). Cardiac computed tomography scans indicated that target vessel/distal vessel diameter ratio increased from (0.4 ± 0.2) pre-operatively to (0.8 ± 0.2) one year post-procedure and (0.9 ± 0.3) at the final follow-up (<i>p</i> < 0.05). A total of six adverse events were documented, comprising two cases of in-stent restenosis requiring surgical reintervention, three cases of in-stent restenosis managed with regular clinical surveillance, and one case of percutaneous pulmonary valve replacement due to severe pulmonary regurgitation. Kaplan-Meier event-free survival analysis demonstrated that elevated preprocedural right ventricular systolic pressure (>72 mmHg) was significantly associated with long-term adverse events (<i>p</i> = 0.024). <b>Conclusion:</b> Percutaneous stent implantation for residual PAS after surgical repair of complicated CHDs effectively relieves vessel stenosis, stabilizes cardiac function, and improves long-term prognosis in pediatric patients. In-stent restenosis remains an unresolved complication, necessitating further advancements in interventional strategies.
KW  - Percutaneous stent implantation; pulmonary artery stenosis; children

DO  - 10.32604/chd.2025.068286