Transcatheter rehabilitation of pulmonary artery and right ventricle

pulmonary artery stenosis (PAS) occur in at least 2–3% of patients with congenital heart disease (CHD). Stenosis may be discrete or associated with long-segment hypoplasia, and may be congenital or secondary to a surgical procedure. Rarely, stenosis can be caused by mediastinal inflammatory disorders (radiation or fibrosing mediastinitis) or extrinsic compression from neoplasm.The pathophysiologic effects of PAS can be secondary to reduced segmental pulmonary flow (dyspnea, poor lung growth), or to right ventricular (RV) hypertension (right heart failure, arrhythmia, sudden death), or both. Treatment is generally indicated in such patients if RV pressure is more than 65–75% systemic, and in some patients with lower pressures if they have significant symptoms. there are numerous experiences on transcatheter treatment of PAS. Catheter techniques to improve areas of stenosis in the pulmonary artery system have greatly improved outcomes over surgical management alone. The goal of this therapy is to increase flow to underperfused regions of the lung. In these patients, the regional pulmonary blood flow is best assessed with a radionuclide quantitative perfusion scan or MTI.CT or MRI scan can give excellent visualization of pulmonary artery anatomy.Stenoses may be treated by simple balloon angioplasty, cutting balloon angioplasty, or placement of a stent. Restenosis may occur in 12% of cases. Long-term echocardiography and an occasional radionuclide perfusion scan may be sufficient for the follow-up of simple, proximal stenotic lesions. CT or MRI or repeat angiography may be necessary for evaluation of more distal lesions. Here we report the pulmonary artery angioplasty procedures witch have been done in a few patients in shahid madani heart center at northwest of Iran.