Application of pulmonary artery banding for complex congenital heart defects in children

Abstract

Objective To discuss the application of pulmonary artery banding(PAB)in the treatment of complex congenital heart defect in children and evaluate the result of the procedure.Methods Thirty-two children with complex congenital heart defects underwent pulmonary artery banding procedure in our center from Jan 2002 to Mar 2007.There are 22 boys and 10 girls,the mean age was(9.2±18.0)months,the mean body weight was(6.1±3.9)kg,the mean saturation was(89.5±6.3)%.The diameter of main pulmonary artery was(16.3±3.0)mm by echocardiography and mean pulmonary artery pressure was(44.5±7.6)mmHg before operation.The mean postoperative circumstance of main pulmonary artery was(28.0±4.1)mm,and the mean pressure gradient over the banding was(43.7±9.0)mmHg.Results There was one postoperative death because of infection,and 2 cases underwent rebanding procedure.The mean ventilation time was(44.3±164.9)hrs and the mean ICU stay time was(4.1±7.1)d.The postoperative saturation was(82.7±9.1)%.The morbidity was 4/31.Thirty-one cases were followed up from 1 month to 5 years.Twenty-two cases un derwent the 2nd stage procedure while the banding belts were taken down and 11 cases underwent the pulmonary artery angioplasty.Conclusions The pulmonaty artery banding procedure can limit the pulmonary blood flow to protect the pulmonary vessels and retrain the left ventricle in d-TGA cases.It is a safe palliative procedure with satisfying operative results,followed by biventricular repair or univentricular repair as further surgical intervention. Key words: Heart diseases,congenital; Pulmonary artery; Cardiac surgical procedures