The Treatment Dilemma in Adult Patients with Peripheral Pulmonary Artery Stenosis of Diverse Etiologies

Overview

Journal Egypt Heart J

Publisher Springer

Specialty Cardiology & Vascular Diseases

Date 2021 Jul 15

PMID 34264403

Citations 1

Authors

Zahra Hosseini

Ata Firouzi

Bahram Mohebbi

Ehsan Khalilipur

Mohammadreza Baay

Kiara Rezaei Kalantari

Iman Harirforoosh

Zahra Khajali

Affiliations

Soon will be listed here.

Abstract

Background: Peripheral pulmonary artery stenosis (PPAS) is a rare and underdiagnosed phenomenon that is reported infrequently in adult patients. Most patients with PPAS have concomitant congenital heart diseases, a history of palliative surgical therapies during childhood, or syndromic characteristics. Acquired cases are rare, and they are underestimated in adulthood and managed inappropriately.

Case Presentation: This case series describes 3 adult patients with PPAS of diverse etiologies and discusses their underlying causes, diagnostic modalities, and treatment strategies.

Conclusions: In patients with PPAS, sufficient heed should be paid to endovascular interventions such as balloon dilation and primary or bailout stenting, not least vis-à-vis the type and size of balloons or stents as well as complications and preventive strategies.

Citing Articles

Adult-onset idiopathic peripheral pulmonary artery stenosis.

Tamura Y, Tamura Y, Shigeta A, Hosokawa K, Taniguchi Y, Inami T Eur Respir J. 2023; 62(6).

PMID: 38061784 PMC: 10733597. DOI: 10.1183/13993003.00763-2023.

References

Mainwaring R, Ibrahimiye A, Hanley F . Surgical Technique for Repair of Peripheral Pulmonary Artery Stenosis and Other Complex Peripheral Reconstructions. Ann Thorac Surg. 2016; 102(2):e181-3. DOI: 10.1016/j.athoracsur.2016.03.028. View

Kim H, Sung S, Chang Y, Lee H, Park J . Early and midterm outcomes of left pulmonary artery angioplasty using an anterior wall flap of the main pulmonary artery in tetralogy of Fallot repair. J Thorac Cardiovasc Surg. 2013; 148(6):2597-601. DOI: 10.1016/j.jtcvs.2013.10.060. View

Kushner T, Halperin J, Nair A, Fuster V, Love B . Peripheral pulmonary artery stenosis masquerading as pulmonary hypertension: a diagnostic and therapeutic challenge. Vasc Med. 2012; 17(4):235-8. DOI: 10.1177/1358863X12451207. View

Mainwaring R, Hanley F . Surgical Techniques for Repair of Peripheral Pulmonary Artery Stenosis. Semin Thorac Cardiovasc Surg. 2017; 29(2):198-205. DOI: 10.1053/j.semtcvs.2017.05.001. View

Baerlocher L, Kretschmar O, Harpes P, Arbenz U, Berger F, Knirsch W . Stent implantation and balloon angioplasty for treatment of branch pulmonary artery stenosis in children. Clin Res Cardiol. 2008; 97(5):310-7. DOI: 10.1007/s00392-007-0631-8. View

McMahon C, El Said H, Vincent J, Grifka R, Nihill M, Ing F . Refinements in the implantation of pulmonary arterial stents: impact on morbidity and mortality of the procedure over the last two decades. Cardiol Young. 2005; 12(5):445-52. DOI: 10.1017/s1047951102000768. View

Claudio M, Barrocas M, Pifarre R, NEVILLE W, MEADOWS W, Sharp J . Peripheral pulmonary artery stenosis secondary to chronic pulmonary thromboembolic disease. Am J Cardiol. 1970; 25(4):495-500. DOI: 10.1016/0002-9149(70)90020-2. View

Sugiyama H, Veldtman G, Norgard G, Lee K, Chaturvedi R, Benson L . Bladed balloon angioplasty for peripheral pulmonary artery stenosis. Catheter Cardiovasc Interv. 2004; 62(1):71-7. DOI: 10.1002/ccd.20030. View

Martin E, Mainwaring R, Collins 2nd R, MacMillen K, Hanley F . Surgical Repair of Peripheral Pulmonary Artery Stenosis in Patients Without Williams or Alagille Syndromes. Semin Thorac Cardiovasc Surg. 2020; 32(4):973-979. DOI: 10.1053/j.semtcvs.2020.01.003. View

10.

Ngo M, Aggarwal A, Knudson J . Peripheral pulmonary artery stenosis: an unusual case and discussion of genetic associations. Congenit Heart Dis. 2014; 9(5):448-52. DOI: 10.1111/chd.12198. View

11.

Gandy K, Tweddell J, Pelech A . How we approach peripheral pulmonary stenosis in Williams-Beuren syndrome. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2009; :118-21. DOI: 10.1053/j.pcsu.2009.01.012. View

12.

Kan J, Marvin Jr W, Bass J, MUSTER A, Murphy J . Balloon angioplasty--branch pulmonary artery stenosis: results from the Valvuloplasty and Angioplasty of Congenital Anomalies Registry. Am J Cardiol. 1990; 65(11):798-801. DOI: 10.1016/0002-9149(90)91391-i. View

13.

Tonelli A, Ahmed M, Hamed F, Prieto L . Peripheral pulmonary artery stenosis as a cause of pulmonary hypertension in adults. Pulm Circ. 2015; 5(1):204-10. PMC: 4405719. DOI: 10.1086/679727. View

14.

Ko S, Komuro J, Katsumata Y, Shiraishi Y, Kawakami T, Yamada Y . Peripheral pulmonary stenosis with Noonan syndrome treated by balloon pulmonary angioplasty. Pulm Circ. 2020; 10(4):2045894020954310. PMC: 7675873. DOI: 10.1177/2045894020954310. View

15.

Alizadehasl A, Saedi S, Ganji H, Pourafkari L . Isolated peripheral pulmonary stenosis in Takayasu arteritis. Int J Rheum Dis. 2019; 23(1):116-119. DOI: 10.1111/1756-185X.13742. View

16.

Qin L, Hong-Liang Z, Zhi-Hong L, Chang-Ming X, Xin-Hai N . Percutaneous transluminal angioplasty and stenting for pulmonary stenosis due to Takayasu's arteritis: clinical outcome and four-year follow-up. Clin Cardiol. 2009; 32(11):639-43. PMC: 6653073. DOI: 10.1002/clc.20665. View

17.

Arnold L, Keane J, Kan J, Fellows K, Lock J . Transient unilateral pulmonary edema after successful balloon dilation of peripheral pulmonary artery stenosis. Am J Cardiol. 1988; 62(4):327-30. DOI: 10.1016/0002-9149(88)90239-1. View

18.

Inglessis I, Landzberg M . Interventional catheterization in adult congenital heart disease. Circulation. 2007; 115(12):1622-33. DOI: 10.1161/CIRCULATIONAHA.105.592428. View

19.

Goo H . Computed Tomography Pulmonary Vascular Volume Ratio Can Be Used to Evaluate the Effectiveness of Pulmonary Angioplasty in Peripheral Pulmonary Artery Stenosis. Korean J Radiol. 2019; 20(10):1422-1430. PMC: 6757002. DOI: 10.3348/kjr.2019.0286. View