Feasibility and related outcome of intraluminal pulmonary artery banding

Sandrio S, Purbojo A, Arndt F, Toka O, Glöckler M, Dittrich S, Cesnjevar R, Rueffer A (2015)

Publication Type: Journal article

Publication year: 2015

Journal

Publisher: Elsevier / Oxford University Press (OUP): Policy H

Book Volume: 48

Pages Range: 470-80

Journal Issue: 3

DOI: 10.1093/ejcts/ezu464

Abstract

This retrospective study evaluated the feasibility and related outcome of intraluminal pulmonary artery banding (I-PAB).Thirty-two children underwent I-PAB between July 2006 and April 2014. The median age and weight were 60 days (range: 5 days to 4.2 years) and 3.7 kg (range: 2.6-13.0 kg), respectively. Cardiac diagnoses included single ventricle morphology (n = 11), complex ventricular septal defects (n = 11), balanced atrioventricular septal defects (n = 3), congenitally corrected transposition of the great arteries (n = 2) and aortic arch hypoplasia with ventricular septal defects (n = 5). On cardiopulmonary bypass (CPB), 2 I-PAB modifications with either 1 (n = 24) or 2 ('hour-glass-technique', n = 8) fenestrated pericardial patches were performed.The median fenestration size was 5 mm (range: 4-6.5 mm). In 18 patients I-PAB was a solitary procedure; in 3 of them the decision was made intraoperatively. There was no hospital mortality. The median interval to debanding was 189 days (range: 112 days to 2.6 years). During this period, we observed a significant increase in the pressure gradient over I-PAB (P < 0.01), whereas arterial saturations remained stable. Four patients received balloon dilatation of I-PAB to prolong the palliation period. No patient experienced band occlusion, pulmonary hypertension related to I-PAB, coronary or pulmonary valve impairment. Debanding was performed in 27 patients and one of them required pulmonary patch arterioplasty due to I-PAB-associated pulmonary trunk distortion. Three patients are still awaiting further surgery. There were 2 late deaths prior to, and 3 after debanding, all not related to I-PAB.I-PAB with an exactly defined internal orifice is feasible and effective. Although arterial saturations seem to remain stable, balloon dilatation of I-PAB can be performed safely and efficiently in order to prolong the palliation period. The rate of I-PAB-related complications is low, which might improve the long-term patient outcome. Therefore, despite requiring CPB, I-PAB is our institutional preference for children who require pulmonary artery banding.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE)

How to cite

APA:

Sandrio, S., Purbojo, A., Arndt, F., Toka, O., Glöckler, M., Dittrich, S.,... Rueffer, A. (2015). Feasibility and related outcome of intraluminal pulmonary artery banding. European Journal of Cardio-Thoracic Surgery, 48(3), 470-80. https://doi.org/10.1093/ejcts/ezu464

MLA:

Sandrio, Stany, et al. "Feasibility and related outcome of intraluminal pulmonary artery banding." European Journal of Cardio-Thoracic Surgery 48.3 (2015): 470-80.

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