Treatments for peripheral pulmonary stenosis in children

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Contact the Heart Center

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:

  • what other heart problems—if any—she may have
  • her symptoms
  • the extent of narrowing within the pulmonary branches
  • her overall health
  • the preferences expressed by you and your family

Treatments for peripheral pulmonary stenosis

Monitoring

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.

Medication

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:

  • help the heart maintain healthy function and blood flow
  • control blood pressure
  • prevent abnormal heart rhythms, called arrhythmias

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.

Interventional catheterization

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.

Balloon dilation

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.

Transplant

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.

Coping and support

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:

  • Boston Children's Behavioral Medicine Clinic helps kids who are being treated on an outpatient basis at the hospital—as well as their families—understand and cope with their feelings about:
    • being sick
    • facing uncomfortable procedures
    • handling pain
    • taking medication
    • preparing for surgery
    • changes in friendships and family relationships
    • managing school while dealing with an illness
    • grief and loss
  • The Cardiac Experience Journal was designed by Boston Children's psychiatrist-in-chief David DeMaso, MD, and members of his team. This online collection features thoughts, reflections and advice from kids and caregivers about going through cardiac disease, heart transplants and many other medical experiences.
     
  • Boston Children's Psychiatry Consultation Service is comprised of expert and compassionate pediatric psychologists, psychiatrists, social workers and other mental health professionals who understand the unique circumstances of hospitalized children and their families. The team provides several services, including:
    • short-term therapy for children admitted to one of our inpatient units
    • parent and sibling consultations
    • teaching healthy coping skills for the whole family
    • educating members of the medical treatment team about the relationship between physical illness and psychological distress
  • Boston Children's Department of Psychiatry offers a free booklet, “Helping Your Child with Medical Experiences: A Practical Parent Guide” (Adobe Acrobat is required). Topics in the booklet include:
    • talking to your child about his or her condition
    • preparing for surgery and hospitalization
    • supporting siblings
    • taking care of yourself during your child's illness
    • adjusting to life after treatment
  • Boston Children's   Center for Families is dedicated to helping families locate the information and resources they need to better understand their child's particular condition and take part in their care. All patients, families and health professionals are welcome to use the center's services at no extra cost. The center is open Monday through Friday from 8 a.m. to 7 p.m., and on Saturdays from 9 a.m. to 1 p.m. Please call 617-355-6279 for more information.
     
  • The  Boston Children's chaplaincy is a source of spiritual support for parents and family members. Our program includes nearly a dozen clergy members—representing Episcopal, Jewish, Lutheran, Muslim, Roman Catholic, Unitarian and United Church of Christ traditions—who will listen to you, pray with you and help you observe your own faith practices during your child's treatment.
     
  • For children and families affected by life-threatening illness, our Pediatric Advanced Care Team (PACT) is available to provide supportive treatments intended to optimize the quality of life and promote healing and comfort. In addition, PACT can provide emotional support and help arrange end-of-life care when necessary. Please call 617-632-5042 for more information.
     
  • Boston Children's Integrative Therapies Team provides a number of services for hospitalized children, their families and their caregivers, including:
    • massage therapy
    • acupuncture
    • yoga
    • therapeutic touch
  • Boston Children's International Center is a dedicated resource for patients and families from countries outside the United States. The center can provide assistance with everything from reviewing medical records to setting up appointments and locating lodging. Contact the center by phone at 01-617-355-5209 or via e-mail at international.center@childrens.harvard.edu.

View a general guide for Boston Children's patients and their families.

Helpful links

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

Did you know?

Boston Children's helps adults with congenital heart defects, too.


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- Sandra L. Fenwick, President and CEO

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