Efficacy of Noncompliant Balloons in The Treatment of Postoperative Pulmonary Artery Stenosis

Abstract

Background: Balloon dilatation for postoperative pulmonary artery stenosis is important to adjust pulmonary circulation. In semi-compliant balloons, pressure imbalance on inflation （“dog bone appearance”） remains a problem. Recently, the use of noncompliant balloons is increasing because of improved catheter tracking.
Purpose: To validate the efficacy of noncompliant balloons in the treatment of postoperative pulmonary stenosis by assessing waist release and pulmonary artery expansion.
Method: This retrospective study included 136 patients （154 lesions） who underwent balloon dilatation for postoperative pulmonary stenosis at Saitama Medical University International Medical Center between April 2007 and April 2013.
Results: The patients were divided into 2 groups: the semi-compliant balloon group （70 patients ［78 lesions］） and the noncompliant balloon group （66 patients ［76 lesions］）. After balloon dilatation, waist release was achieved for 35 of 78 lesions （45%） in the semi-compliant balloon group and 61 of 76 lesions （80%） in the noncompliant balloon group （p < 0.001）. The expansion rates were 121 ± 2.3% in the semi-compliant balloon group and 139 ± 2.1% in the noncompliant balloon group （p < 0.001）. The balloon size ratios for stenotic lesions were 259 ± 6.6% in the semi-compliant balloon group and 214.9 ± 6.1% in the noncompliant balloon group （p < 0.001）.
Conclusion: noncompliant balloon resolved postoperative pulmonary stenosis more effectively with a smaller balloon size compared with semi-compliant balloon. The use of noncompliant balloon may increase with appropriate patient selection.