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Pulmonary Artery Stenosis

Date: 2018-01-10
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Definition and Classification

Pulmonary artery stenosis belongs to peripheral arterial stenosis, it can be isolated or concomitant with other heart diseasesis. It is one of the most common congenital heart disease, accounting for 8-10% of congenital heart disease. Pulmonary artery stenosis could be the only malformation, and could also be one kind of malformation of Tetralogy of Fallot or Trilogy of fallot. Tetralogy of Fallot is the most common type of cyanotic congenital heart disease with the incidence up to 10%. Pulmonary artery stenosis can be divided into 3 types, pulmonary valve stenosis, right ventricular infundibular stenosis (subvalvular pulmonary artery stenosis) and supvalvular pulmonary artery stenosis. Types of stenosis can coexist. Valvular stenosis is the most common, accounting for 70-80%.

 

Symptoms and Risks

If early intervention is not timely performed, congenital pulmonary artery stenosis would easily lead to pulmonary vascular and tissue maldevelopment, increased right ventricular pressure, right ventricular hypertrophy, tricuspid insufficiency or other complications, even can be life-threatening. Patients with mild stenosis can be no symptoms. Patients with moderate stenosis usually have symptoms of palpitation, shortness of breath or fatigue after exercise.

Patients with severe stenosis usually have cyanosis and clubbed fingers. Symptoms such as palpitation, shortness of breath and apsychia usually occur in their daily lives. Even sudden death could happen in these patients. In infant or even neonatal period, these patients often appear heart failure, which would lead to death if not treated. Pulmonary artery stenosis could be diagnosed by echocardiography.

 

Treatment

Current treatments for pulmonary artery stenosis include surgery and intervention. Interventional therapy methods include balloon angioplasty and stenting. Pulmonary artery stenting could effectively eliminate stenosis and transvalvular pressure, and it is one of the preferred treatment forf pulmonary artery stenosis. After surgery, patients with tetralogy of Fallot usually would involve pulmonary artery stenosis. For these kind of patients, intervention has its irreplaceable advantages. Pulmonary artery stent can provide continuous support force to vascular wall, preventing the elastic contraction of the vessel and the compression of the surrounding structure.


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