Journal of JCIC

Multiple pulmonary arterial stenoses cause the right heart failure. The staged dilation for these multiple stenoses is recommended to prevent the reperfusion pulmonary injury. We report successful staged dilation for multiple stenoses of the right pulmonary artery in 69-year-old man. He was diagnosed as malignant fibrous histiocytoma at the left hilar region and received the proton therapy at 59-year-old, but it recurred and total left pneumonectomy was performed at 61-year-old. After that, he complained of exertional dyspnea and was diagnosed with the right heart failure associated with multiple right pulmonary arterial stenoses, which was caused by the proton therapy. He was referred to our center for the catheter intervention to alleviate the multiple stenoses. In the first session, we performed the balloon dilation for the middle and lower branch arteries. In the second session, we deployed P3008 stent for the right main trunk stenosis. In this session, although the balloon had a pin-hole rupture, we expanded the stent successfully using power injection of contrast medium. His right ventricular pressure finally decreased from 90％ to 60％ of his systemic blood pressure. The staged dilation for the multiple pulmonary arterial stenoses can decrease the right ventricular pressure and improve the right heart failure without reperfusion pulmonary injury.