Zuzana Venczelová, Jozef Mašura
Branch pulmonary artery stenosis is a common condition in patients with congenital heart disease. It is found in native form or more often post-surgically. In biventricular circulation, such stenoses cause pressure overload of the right ventricle and its progressive dysfunction; in univentricular anatomy, they can contribute to persistent pleural effusion or protein losing enteropathy. A significant pulmonary branch stenosis can lead to hypoplasia of the peripheral pulmonary vasculature on the affected side. Pulmonary branch stenoses can be relieved interventionally by balloon angioplasty or stent implantation. Balloon angioplasty is generally successful in proximal pulmonary stenoses and in postsurgical stenoses with scar tissue; peripheral pulmonary artery stenoses react to balloon angioplasty less favourably. Stent implantation is advantageous in elastic stenoses and when a pulmonary artery is compressed by adjacent structures, but is of limited use in small children.