Drug-Eluting Balloons Versus Conventional Balloon Angioplasty for Peripheral Pulmonary Artery Stenosis in Childhood

Area of Science:

• Cardiology
• Pediatric Interventional Cardiology

Background:

• Peripheral pulmonary artery stenoses (PAS) are a frequent complication in pediatric patients with congenital heart defects, post-operative conditions, and specific genetic syndromes.
• Effective management of PAS is crucial to prevent long-term sequelae such as right ventricular pressure overload.

Purpose of the Study:

• To compare the efficacy of drug-eluting balloon angioplasty (DEBA) versus conventional balloon angioplasty (CBA) in treating pediatric patients with peripheral pulmonary artery stenoses (PAS).

Main Methods:

• A retrospective analysis of 103 stenoses treated between 2012 and 2022 via cardiac catheterization.
• Patients were divided into DEBA (intervention) and CBA (control) groups, with lumen diameters measured at baseline and follow-up.
• Outcomes assessed included lumen diameter change, hemodynamic improvement, and infant development.

Main Results:

• DEBA treatment resulted in a significantly higher diameter growth rate per month (0.151 mm vs. 0.087 mm) and fractional diameter growth rate per month (4.1% vs. 2.2%) compared to CBA.
• A significant reduction in the right ventricular to systemic arterial pressure ratio was observed in the DEBA group (-6.4% vs. 4.3%).
• The mean follow-up period was 10.2 months.

Conclusions:

• Drug-eluting balloon angioplasty is an effective treatment for pediatric peripheral pulmonary artery stenoses, yielding greater lumen increase than conventional balloon angioplasty.
• DEBA demonstrates a significant benefit in reducing right ventricular pressure load in this patient population.