Initial Experience with Large Jostent in the Treatment of Pulmonary Artery Stenosis with Congenital Heart Disease: Comparison of Clinical Results with Palmaz Stent

Abstract

Purpose: The aim of this study was to assess the efficacy of Jostent (peripheral, large; JS) in the treatment of pulmonary artery stenosis with congenital heart disease (CHD) and report our initial experience with JS.

Methods: Seventy four large-sized stents in 70 patients with CHD were implanted from June 1996 to July 2004. Thirty eight Palmaz stent (large; PS) in 36 patients (PS group) and 36 JS in 34 patients (JS group) were used. Immediate and follow-up results were compared.

Results: All stent placements were successful except 1 procedure with long PS (P308) due to acute angle of passage to the lesion. In both groups, stenosis diameters increased (PS group; 4.1+/-1.3 to 10.3+/-2.0 mm, JS group; 4.2+/-1.9 to 9.9+/-2.9 mm), pressure gradients decreased (PS group; 23.7+/-13.9 to 2.6+/-4.5 mmHg, JS group; 23.8+/-20.8 to 2.6+/-4.5 mmHg) and perfusions to the affected lung improved significantly (PS group; 20.2+/-9.7 to 38.5+/-9.7%, JS group; 16.6+/-8.5 to 36.4+/-10.2%). Redilatation of the implanted stents were feasible and effective except 3 stents in PS group and 1 stent in JS group. There was no significant stenosis or thrombus formation caused by the protruded stents, but failure to get access into the stent for redilatation due to protruded stent orifice was occurred in 1 patient. No significant stent recoil or distortion was observed.

Conclusion: The efficacy and safety of JS in the treatment of pulmonary artery stenosis with CHD is comparable with those of PS. The smooth tip design and flexibility of JS enhances feasibility of the procedure.