The authors report their single-center experience with stent implantation for congenital or postoperative pulmonary vein stenosis in patients < 18 years of age. A total of 47 patients had stents placed in 74 total pulmonary veins from 1990 to 2011. The median age at stent implantation was 1.4 years. Twenty-nine patients had prior pulmonary vein surgery, and 24 had previous transcatheter pulmonary vein intervention. The choice of stents was bare metal (57), drug-eluting (7), and covered (11). Stenosis was acutely relieved in all veins. Median RV systolic pressure decreased from 69 to 58mm Hg, while median RV to aortic systolic pressure ratio decreased from 0.9 to 0.6. Significant complications occurred in five cases – one cardiac perforation and four cardiac arrests. 

Stent embolization or migration occurred in 8% of cases. During median cross-sectional follow-up of 3.1 years, 21 patients died. Estimated survival was 62±8% at one year and 50±8% at five years. Fifty-four stents underwent reevaluation with catheterization at a median of 3.9 months post-implantation, with interventions performed on 32 at a median of 4.3 months. Freedom from reintervention was 62±7% at six months and 42±7% at one year. At a median of 4.2 months, nine showed total occlusion. Twenty-eight stents showed in-stent narrowing at the first follow-up catheterization. Stent implantation diameter of ³ 7 mm was associated with more extended freedom from reintervention. 

All editors: Gary E. Stapleton, MD, FSCAI