Percutaneous balloon dilation angioplasty of pulmonary artery branch stenosis

Congenital or acquired branch pulmonary artery stenosis can produce significant right ventricular hypertension and complicate the management of patients with tetralogy of Fallot. Repair is difficult using conventional surgical techniques. Balloon dilation angioplasty may be beneficial to some patients with these lesions. The technique currently used at the University of Minnesota is described. Results indicate that half of attempted dilations are successful with increased diameter of the narrowed areas, decreased pressure gradient, and improved pulmonary blood flow to the involved lung. Failure may be caused by technical limitations (28%) or lesions that are not dilatable with current equipment (22%). Undilatable lesions are more common in children over 2 years of age, in isolated pulmonary artery stenosis, and with associated surgical shunts. Complications are uncommon.