Related Experiment Videos
[Two stage surgical treatment of large ventricular septal defects (author's transl)]
Insights
Pulmonary artery banding (PAB) in infants with large ventricular septal defects (VSD) and pulmonary hypertension showed a 24% mortality rate. Isolated VSD cases had the lowest mortality, with subsequent VSD closure and debanding achieving a 10.7% operative mortality.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Critical Care Medicine
Context:
- Large ventricular septal defects (VSD) with pulmonary hypertension pose significant challenges in infants.
- Pulmonary artery banding (PAB) is a palliative surgical procedure used in managing these complex congenital heart defects.
Purpose:
- To evaluate the outcomes and mortality associated with pulmonary artery banding (PAB) in infants diagnosed with large ventricular septal defects (VSD) and pulmonary hypertension.
Summary:
- This study reviewed 51 infants undergoing PAB for large VSD and pulmonary hypertension between March 1971 and the study period. 80% of infants were under six months old, and 41% had additional cardiac defects. Overall mortality was 24%, with the lowest rates observed in isolated VSD cases (6.7%). Of the survivors, 28 underwent subsequent VSD closure and pulmonary artery debanding, with an operative mortality of 10.7%. Post-debanding catheterization data indicated normal pulmonary pressures and resistance in most cases.
Impact:
- Pulmonary artery banding can be an effective palliative strategy for infants with large VSD and pulmonary hypertension, although significant mortality exists.
- The study highlights the importance of considering associated defects and the staged approach for VSD closure and debanding to improve long-term outcomes.
- Findings provide valuable data for surgical decision-making and risk assessment in the management of complex congenital heart disease.
Abstract:
Since March 1971, 51 infants were subjected to pulmonary artery banding (PAB) for a large ventricular septal defect (VSD) with pulmonary hypertension. 41 infants (80%) were under six months of age. Additional defects were present in 41%. Twelve babies died (24%). The lowest mortality was achieved in isolated VSD (6,7%). 28 patients subsequently underwent VSD closure and pulmonary artery debanding. Catheterization data revealed normal or slightly elevated pressures and normal vascular resistance in the pulmonary circuit in 22 children. The operative mortality rate was 10,7%.