Outcomes and Patency After Surgical Repair of Previously Stented Pulmonary Veins in Pediatric Patients.

Abstract

The study objective was to evaluate surgical outcomes of patients having had catheter-based pulmonary vein (PV) stents implanted with subsequent pulmonary vein stenosis (PVS) repair in a large, single-center cohort. Clinical data were retrospectively reviewed from a PVS registry identifying patients who had prior PV stents placed, had in-stent stenosis, and required subsequent PVS repair. Between September 2007 and July 2023, 251 patients underwent surgical PVS repair, of whom 42 (17%) had prior PV stents implanted. Bilateral stents were present in 19 patients (45%). Thirty-one patients (74%) had at least 1 prior PV operation. Median follow-up was 8 months (interquartile range, 3-36 months). Thirty-one patients (74%) underwent postoperative catheter reintervention to maintain patency, and 6 patients (14%) underwent surgical reoperation. Overall, survival at discharge was 95%, and in the modern era, 65% survived at last follow-up. There were similar survival outcomes in PVS patients undergoing surgery with and without prior stents (P = .23). Of the individual veins in patients with prior stents, 84% (n = 97) of stented veins were patent at last follow-up. Increasing numbers of patients are undergoing catheter-based PV stent interventions for severe recurrent PVS. Despite this, there are reasons to be hopeful, with 84% of these veins patent at most recent follow-up, and no difference in survival of patients with or without preoperative stent placement.