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  • Title: Pulmonary vein stenosis: initial experience with cutting balloon angioplasty.
    Author: Seale AN, Daubeney PE, Magee AG, Rigby ML.
    Journal: Heart; 2006 Jun; 92(6):815-20. PubMed ID: 16278274.
    Abstract:
    OBJECTIVE: To determine the safety and effectiveness 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 PVSs were treated during 12 catheterisation procedures. Median patient age at the time of procedure was 12.5 months (range 1.5-36 months) and weight was 7.1 kg (range 2.8-11.1 kg). Minimum pulmonary vein diameter increased significantly on angiography after cutting balloon angioplasty, from mean (SD) 2.3 (0.7) mm to 4.2 (1.9) mm, mean of differences 1.9 mm (95% confidence interval (CI) 0.9 to 2.9 mm, p = 0.0013). Mean (SD) oxygen saturation rose from 79.6 (12.9)% to 83.9 (9.0)%, mean of differences 4.3% (95% CI 0.7% to 8.0%, p = 0.0238). All children's symptoms improved subjectively. Tricuspid regurgitant jet velocity did not change significantly. 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.
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