"Test banding" of the pulmonary artery with a balloon-tipped catheter. Technique for evaluation of pulmonary arteriolar reactivity in children with pulmonary hypertension secondary to ventricular septal defects.

Abstract

The reactivity of the pulmonary arteriolar bed is determined by "test banding" the pulmonary artery from within. This is accomplished with a double-lumen, balloon-tipped catheter. In the absence of irreversible pulmonary vascular obstructive disease, inflation of the balloon in the pulmonary artery results in a sustained fall in pulmonary artery pressure and a sustained increase in systemic arterial pressure. The technique, performed as an adjunct to the diagnostic catheterization of any patient with significantly elevated pulmonary vascular resistance, is a means of obtaining a preoperative assessment of pulmonary arteriolar reactivity. Three patients in this study were shown to have reactive pulmonary arterioles although they all had pulmonic:systemic flow ratios of 1.3:1 or less and pulmonic:systemic pressure and resistance ratios greater than 0.75, and failed to respond to 100% oxygen inhalation and tolazoline injection.