16:20 〜 17:10
[II-JCKO5-04] Hybrid pulmonary vein stenting in the patients with refractory to surgical pulmonary vein stenosis repair
Back ground:
Pulmonary vein stenosis(PVS) is still frustrating disease, especially in the patient with multiple severe PVS. We performed hybrid pulmonary vein(PV) stent placement successfully in the 5 patients who underwent multiple surgery for severe PVS after TAPVR repair.
Cases and review:
5 patients were identified between 2013 and 2016, who underwent hybrid PV stenting for malignant PVS. We performed hybrid PV stent placement on one patient who had progressive multiple PVS and severe pulmonary hypertension despite recurrent surgical PV widening after cardiac type TAPVR repair. After hybrid stenting with coronary drug eluting stent (DES) and surgical pulmonary vein angioplasty, PVS was relieved and pulmonary hypertension was improved. Other 2 patients had severe multiple PVS after mixed type TAPVR repair. These patients underwent hybrid PV stenting with bare-metal stent (BMS) and PV ballooning. Last 2 patients who was diagnosed as functional single ventricle with pulmonary atresia and supra-cardiac type TAPVR developed progressive severe PVS after TAPVR repair. These patients also underwent hybrid stent placement. Hybrid PV stenting resulted in sufficient relief of PVS to permit clinical stabilization in all patients. All patients received aspirin and clopidogrel after the operation. 3 patients had undergone several elective further catheterizations for PV ballooning or large stent insertion after hybrid stenting procedure.
Conclusion:
Even though the prognosis of severe multiple PVS is very poor, hybrid PV stent placement could be a good palliation in this patient group.
Pulmonary vein stenosis(PVS) is still frustrating disease, especially in the patient with multiple severe PVS. We performed hybrid pulmonary vein(PV) stent placement successfully in the 5 patients who underwent multiple surgery for severe PVS after TAPVR repair.
Cases and review:
5 patients were identified between 2013 and 2016, who underwent hybrid PV stenting for malignant PVS. We performed hybrid PV stent placement on one patient who had progressive multiple PVS and severe pulmonary hypertension despite recurrent surgical PV widening after cardiac type TAPVR repair. After hybrid stenting with coronary drug eluting stent (DES) and surgical pulmonary vein angioplasty, PVS was relieved and pulmonary hypertension was improved. Other 2 patients had severe multiple PVS after mixed type TAPVR repair. These patients underwent hybrid PV stenting with bare-metal stent (BMS) and PV ballooning. Last 2 patients who was diagnosed as functional single ventricle with pulmonary atresia and supra-cardiac type TAPVR developed progressive severe PVS after TAPVR repair. These patients also underwent hybrid stent placement. Hybrid PV stenting resulted in sufficient relief of PVS to permit clinical stabilization in all patients. All patients received aspirin and clopidogrel after the operation. 3 patients had undergone several elective further catheterizations for PV ballooning or large stent insertion after hybrid stenting procedure.
Conclusion:
Even though the prognosis of severe multiple PVS is very poor, hybrid PV stent placement could be a good palliation in this patient group.