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

Abstract

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. 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. There was no early mortality (30days). 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 8mm RV-PA (right ventricle-pulmonary artery) conduit was available for respective patients. Although further studies are warranted, our strategy might prove to be a valid clinical option for the treatment of severe congenital heart diseases.