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There are many ways you can help children and their families get the care they need.
Boston Children's pediatric heart team has many years of expertise in treating all types of heart defects and heart disease.
Our clinicians have extensive experience in treating every stage of peripheral pulmonary stenosis in children, adolescents and adults, as well as in utero. We use minimally invasive techniques—medical and surgical procedures that use small incisions and miniaturized cameras and tools—whenever we can. In fact, Boston Children's has a Center for Minimally Invasive Surgery that is a global leader in creating and refining new surgical approaches, and our Interventional Catheterization Program has given our clinicians an important new alternative to open-heart surgery for many children with heart conditions.
Your child's exact treatment plan will be determined by:
Children with mild to moderate peripheral pulmonary stenosis may not require any treatment other than routine monitoring in the short term, since they have no noticeable symptoms that affect their daily lives.
Your child's cardiologist will regularly evaluate your child for any sign of further narrowing in the pulmonary branches and related complications. Most often, routine monitoring will involve physical examinations and echocardiograms.
Medications is not a cure for peripheral pulmonary stenosis, but can be helpful in managing specific symptoms. In some cases, your child's clinician may prescribe medication to:
A child with peripheral pulmonary stenosis may also need to periodically take antibiotics in order to prevent an infection called bacterial endocarditis. Bacterial endocarditis can cause serious damage to the inner lining of the heart and its valves. You should always let medical personnel know about your child's peripheral pulmonary stenosis before making arrangements for a medical procedure, even if the procedure seems minor or unrelated to your child's cardiac care.
If your child has peripheral pulmonary stenosis, but no other cardiac problems, he probably will not need antibiotics before a routine dental procedure (for example, a teeth-cleaning).
Learn more about commonly prescribed medications.
Boston Children's has a program dedicated to interventional catheterization, the use of a thin tube called a catheter that is threaded from a vein or artery into the heart. The catheter can be used to fix holes in the heart, open narrowed passageways (like those within the pulmonary branches) and create new passageways if needed.
Many children need several interventions over time as they grow and age. The good news is that these interventional catheterization procedures are very effective and carry a low incidence of complications. Children who have these procedures are likely to enjoy healthy adult lives with minimal to no restrictions on playing sports or engaging in other activities. Since peripheral pulmonary stenosis can affect each child differently, you should always speak directly to your treating clinician for a specific treatment plan, outlook and recommendations for your child.
The types of interventional catheterization used to treat peripheral pulmonary stenosis at Boston Children's are balloon dilation, balloon dilation and stent placement and the Cutting Balloon device.
The most common interventional catheterization procedure used here at Children's is balloon dilation. With the child under sedation, a small, flexible catheter is inserted into a blood vessel, most often in the groin. Using tiny, highly precise cameras and tools, clinicians guide the catheter up into the inside of the heart and then into the affected areas of the pulmonary branches. A deflated balloon at the tip of the catheter is inflated once the tube is in place, and this balloon stretches the constricted area open, reversing the problematic narrowing.
Balloon dilation and stent placement
The effects of balloon dilation can be amplified for some children with peripheral pulmonary stenosis by using a combination of balloon dilation and the placement of a balloon-expandable stent—a small, stainless steel tube. The stent is attached to the balloon dilation catheter as it is fed into the narrowed parts of the pulmonary branches.
The protective covering is removed when the catheter is in place, and the balloon is then inflated. The balloon affixes the stent within the pulmonary branch, stretching the narrowed area and keeping it open.
The Cutting Balloon device
In 2008, the United States Food and Drug Administration chose Boston Children's to lead a worldwide, multi-center clinical trial, using a new device called the Cutting Balloon to treat children whose peripheral pulmonary stenosis has not been fixed by standard balloon dilation.
The Cutting Balloon is a balloon with three or four miniature blades attached. These blades are able to make small incisions throughout the narrowed areas of the pulmonary branches, helping to open the problematic narrowings.
Rarely, a child's peripheral pulmonary stenosis cannot be managed adequately with interventional catheterization procedures. For these children, a heart transplant or heart-lung transplant may be necessary.
Learn more about our transplant programs.
When your child has peripheral pulmonary stenosis, your family may have many concerns and questions. Not only are you focused on meeting all of your child's medical needs; you are also grappling with a significant emotional and psychological toll that can affect every member of the family.
In addition to the clinical information offered on this page, Boston Children's has several other resources designed to give your family comfort, support and guidance:
View a general guide for Boston Children's patients and their families.
Please note that neither Boston Children's Hospital nor the Department of Cardiology at Boston Children's unreservedly endorses all of the information found at the sites listed below. These links are provided as a resource.
Helpful links for parents and families
Helpful links for teens
Helpful links for younger children
Boston Children's helps adults with congenital heart defects, too.
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We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”