Revived Role of Pulmonary Artery Band in Management of Heart Failure in Pediatric Dilated Cardiomyopathy.

Abstract

Lack of appropriate durable Ventricular Assist Devices (VADs) that can be managed at home for very young children, and long wait times for transplant have led to search for alternate easily reproducible therapies. In the past decade or more, pulmonary artery banding (PAB), as a new indication of an old technology, has been gradually carried out worldwide as an alternative to mechanical circulatory support in children with end-stage left ventricular dilated cardiomyopathy (DCM) complicated with heart failure(HF), and has achieved encouraging early and mid-term outcomes. Technically, PAB is simple, safe, and effective. This is a promising therapeutic strategy, especially in developing countries where heart transplantation is difficult to implement. As a transition before transplantation, and even a potential treatment, PAB brings more options and hope for children with heart failure who are waiting for transplantation and are refractory to drug therapy. This article reviews the past and current situation, the mechanism, the surgical timing, and application prospect of PAB in the treatment of DCM complicated with heart failure.