30 Years’ Experience in Percutaneous Pulmonary Artery Interventions in Transposition of the Great Arteries
Authors' conclusion
Percutaneous PA interventions are common after ASO and can be performed safely but caution for serious complications is warranted. Unilateral PA stenosis can impact RV pressures. Stents may be more successful at treating PA stenosis compared to BA.
Study context
- Population
- TGA patients with arterial switch operation (ASO) between 1977 and 2022888 survived 30 days with complete follow-up
- Participants
- 960 patients
- Exposure
- Stent vs balloon angioplasty (BA) for pulmonary artery (PA) stenosis after ASO
- Outcome
- Percutaneous PA interventions after ASO
Methodological detailsmulticenter, 2 Dutch congenital heart centers
- Multicenter
- 2 Dutch congenital heart centers
Main finding
As reported in the abstract
Odds ratio (95% CI)P value
Taussig-Bing anomaly
2.8(1.228–6.168)
P = 0.014ASO era 1990 to 1999
4.7(1.762–12.780)
P = 0.002ASO era 2000 to 2009
4.3(1.618–11.330)
P = 0.003- Underwent percutaneous PA interventions
- 77 (9%)
Observational data: associations, not effects.
Further findings
| Outcome | Stent | BA | P value |
|---|---|---|---|
| Invasive post-interventional RV pressure | 47 ± 14 | 58 ± 11 | |
| Post-interventional right PA-PA gradient | 11 ± 11 | 25 ± 12 | P < 0.05 |
| Post-interventional RV/LV pressure ratio | 0.4 ± 0.1 | 0.6 ± 0.2 | P < 0.001 |
Unilateral PA stenosis (left PA 41%, right PA 59%)
- Increased right ventricular (RV) pressure (>30 mm Hg)
- 77%
- RV/LV pressure ratio post- vs pre-intervention
- 0.5 ± 0.2 vs 0.6 ± 0.2, P < 0.05
Safety
Complications, most minor
- Complications
- 17 (13%)
- Post-procedural deaths
- 2
Original publication
30 Years’ Experience in Percutaneous Pulmonary Artery Interventions in Transposition of the Great Arteries. JACC Adv. Published 14 October 2024. doi:10.
Summarised from the published abstract; every number is checked against it