Flow-adjustable bilateral pulmonary artery banding in the neonatal period for severe congenital heart diseases

Gen Thorac Cardiovasc Surg. 2013 Jun;61(6):340-4. doi: 10.1007/s11748-013-0221-9. Epub 2013 Feb 19.

Abstract

Objective: We perform bilateral pulmonary artery banding (BPAB) combined with postoperative percutaneous pulmonary artery balloon dilatation (PABD) as stage I palliation for severe congenital heart diseases. The objective of this study was to evaluate the efficacy of our management strategy for the treatment of severe congenital heart diseases.

Methods: From October 2007 to March 2010, 9 consecutive patients underwent BPAB. Subsequently, all patients had a second-stage operation; we performed biventricular repair for 3 cases and univentricular repair for 6 cases. Clinical data were obtained by retrospectively reviewing medical records.

Results: There was no early mortality (30 days). After the neonatal period, we controlled the pulmonary blood flow to be slightly elevated by PABD. Therefore, the Qp/Qs level was around 1.0, which might contribute to achieving good pulmonary artery growth and avoid intraoperative pulmonary arterioplasty. Except for one patient, intraoperative pulmonary arterioplasty in the second-stage operation was not necessary. Regarding Norwood procedure, an 8 mm RV-PA (right ventricle-pulmonary artery) conduit was available for respective patients.

Conclusions: Although further studies are warranted, our strategy might prove to be a valid clinical option for the treatment of severe congenital heart diseases.

MeSH terms

  • Angioplasty, Balloon
  • Cardiac Catheterization
  • Dilatation
  • Female
  • Heart Defects, Congenital / diagnostic imaging
  • Heart Defects, Congenital / physiopathology
  • Heart Defects, Congenital / surgery*
  • Heart Ventricles / abnormalities
  • Heart Ventricles / physiopathology
  • Heart Ventricles / surgery
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Artery / physiopathology
  • Pulmonary Artery / surgery*
  • Radiography
  • Retrospective Studies