Interventional Strategies for Pulmonary Artery Stenosis After the Arterial Switch Operation

This review examines the incidence, mechanisms, and management of branch pulmonary artery stenosis following the arterial switch operation (ASO) for transposition of the great arteries. We sought to clarify how surgical techniques and anatomical factors contribute to this complication and evaluate the outcomes of different interventional strategies, including balloon angioplasty and stent implantation.

Branch pulmonary artery stenosis is a frequent long-term complication after the ASO, particularly associated with the LeCompte maneuver. Advances in imaging techniques have improved detection, while transcatheter approaches represent the mainstay of treatment. Balloon angioplasty can provide short-term relief but is often limited by restenosis and external compression. Stent implantation has shown higher procedural success and lower reintervention rates, although it carries specific risks in younger patients and requires adaptation to growth.

Pulmonary artery stenosis after an ASO remains a major clinical challenge. Individualized anatomical assessment, early recognition, and tailored interventional strategies are critical for optimizing outcomes. Future research should focus on refining stent technology, hybrid techniques, and long-term surveillance to reduce complications and improve quality of life in this growing patient population.