Surgical Management of Infants with Isolated Supravalvular Pulmonary Stenosis: Case Reports


  • Omer Faruk Dogan
  • Metin Demircin
  • Suheyla Ozkutlu
  • Ilhan Pasaoglu



Pulmonary stenosis (PS) can be seen from the right ventricular outflow tract to the peripheral pulmonary arteries. Most frequently, the obstruction occurs at the level of the pulmonary valve; however, it occurs less frequently at the infindibular level within the trabecular component of the right ventricle or within the pulmonary arterial pathways. Lesions at any of these levels can occur as part of more congenital cardiac malformations such as tetralogy of Fallot, complete transposition of great arteries, or atrial septal defect. Isolated supravalvular pulmonary stenosis (iSPS) is less common than other types of PS. In this study, we present our experience with 4 patients who underwent cardiopulmonary bypass operation for iSPS. In one patient, the circular stenotic area was noted on the touch point of the pulmonary valve. Right ventricular pressures ranged from 70 to 90 mmHg, and the pulmonary artery mean pressures ranged from 14 to 17 mmHg. In all patients, the left ventricular and aortic systolic, diastolic, and mean pressures were moderately increased. Pulmonary artery stenosis was treated successfully using a pericardial or Dacron patch on cardiopulmonary bypass. Various techniques such as balloon dilation have been proposed to deal with this problem, but these may often be unsuccessful because of the elasticity and recoil of the pulmonary artery constrictive ring. Even though endovascular stenting and/or balloon angioplasty have been recently proposed as an initial treatment strategy, they may be associated with some severe complications including pulmonary artery thrombosis or stent migration. Our study, even though it consists of a limited number of cases, suggests that open heart surgery using an oval-shaped patch may be a used as the other main choice for the treatment of iSPS.


Alagille D, Odievre M, Gautier M, Dommergues JP. 1975. Hepatic ductular hypoplasia. Associated with characteristic facies, vertebral malformations, retarded physical, mental, and sexual development, and cardiac murmur. J Pediatr 86:63-71.nArnold LW, Keane JF, Kan JS, et al. 1988. Transient unilateral pulmonary edema following successful balloon dilation of peripheral pulmonary artery stenosis. Am J Cardiol 62:327-30.nFogelman R, Nykanen D, Smallhorn JF, et al. 1995. Endovascular stents in the pulmonary circulation. Circulation 92:881-5.nHastraiter AR, Joorabchi B, Pujatti G, van der Horst RL, Patacsil G, Sever JL. 1967. Cardiovascular lesion associated with congenital rubella. J Pediatr 71:59-65.nBacha EA, Kalimi R, Starr JP, Quinones J, Koenig P. 2004. Autologous repair of supravalvular pulmonic stenosis. Ann Thorac Surg 77:734-6.nCastenada A. 1994. Stent enlargement of pulmonary artery. In: Castaneda A, Jonas RA, Mayer JE, eds. Cardiac Surgery of the Neonate and Infant. Philadelphia, Penn: W. B. Saunders Company; 130.nRowe RD, Vlad P, eds. 1978. Heart Disease in Infancy and Childhood. 3rd ed. New York, NY: MacMillan; 789-801.nSchlesenger FG, Meester GT. 1967. Supravalvular stenosis of the pulmonary artery. Br Heart J 29:829-37.nWilliams JCP, Barrat-Boyes BG, Lowe JB. 1961. Supravalvular aortic stenosis. Circulation 24:1311-8.nRoberts N, Chir B, Moes CAF. 1973. Supravalvular pulmonary stenosis. J Pediatr 82:838-44.nRothman A, Perry SB, Keane JF, et al. 1990. Early results and follow up of balloon angioplasty for branch pulmonary artery stenosis. J Am Coll Cardiol 15:1109-17.nRowe RD. 1963. Maternal rubella and pulmonary artery stenosis: report of eleven cases. Pediatrics 32:180-5.nHosking MC, Thomaidis C, Hamilton R, Burrow SPE, Freedom RM, Benson LN. 1992. Clinical impact of balloon angioplasty for branch pulmonary arterial stenosis. Am J Cardiol 69:1467-70.nMcGoon DC, Kincaid OW. 1964. Stenosis of the pulmonary artery: surgical repair. Med Clinic N Amer 48:1083-8.n



How to Cite

Dogan, O. F., Demircin, M., Ozkutlu, S., & Pasaoglu, I. (2006). Surgical Management of Infants with Isolated Supravalvular Pulmonary Stenosis: Case Reports. The Heart Surgery Forum, 9(4), E668-E674.




Most read articles by the same author(s)

1 2 3 > >>