Pulmonary Artery Banding in Infants with Complex Congenital Heart Defects

Abstract

Pulmonary artery banding was performed in 60 patients with complex congenital heart defects, other than isolated ventricular septal defect, for treatment of high-output cardiac failure with a large left-to-right shunt and pulmonary hypertension. The average age at banding was 3.3 months. Half of the patients also had ligation of a patent ductus arteriosus, resection of coarctation, or creation of an atrial septal defect at the time of banding. Forty-one of the group survived banding; there was a higher survival rate in the patients 3 months of age or older. Twelve patients had catheterization studies performed after banding that demonstrated reduction in pulmonary artery pressure, decrease in the left-to-right shunt, no increase in pulmonary vascular resistance, and significant reduction in left ventricular end-diastolic volume and mass. Eight patients subsequently underwent additional palliative procedures with 7 survivors. Nine patients have had corrective operations performed, and 7 have survived. Pulmonary artery banding is an effective procedure in the staged treatment of infants with complex congenital heart defects.