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Absorbable pulmonary artery banding in tricuspid atresia
1Département de Cardiologie Pédiatrique, H pital Necker-Enfants Malades, Assistance Publique-H pitaux de Paris, France. damien.bonnet@nck.ap-hop-paris.fr
Insights
Polydioxanone ribbon pulmonary artery banding successfully restricted a ventricular septal defect in a child with tricuspid atresia. This absorbable technique offers a novel surgical option for complex congenital heart disease in infants.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Surgery
- Biomaterials in Medicine
Background:
- Tricuspid atresia presents complex challenges in single ventricle physiology.
- Managing elevated pulmonary artery pressure and large ventricular septal defects is critical in neonates.
- Current surgical strategies may have limitations in early infancy.
Observation:
- A child with tricuspid atresia, concordant ventriculoarterial connections, and a large ventricular septal defect had elevated pulmonary artery pressure.
- Pulmonary artery banding was performed using a polydioxanone ribbon, a biodegradable material.
- The procedure aimed to induce restriction in the ventricular septal defect and manage pulmonary blood flow.
Findings:
- The polydioxanone ribbon effectively achieved pulmonary artery banding.
- The ventricular septal defect became restrictive post-procedure.
- The polydioxanone banding material was fully absorbed by the body within 5 months, leaving no residual implant.
Implications:
- This biodegradable pulmonary artery banding technique offers a potential surgical solution for complex congenital heart disease.
- It may be particularly beneficial for infants with single-ventricle physiology and insufficient subpulmonary stenosis.
- The absorbable nature of the polydioxanone ribbon avoids the need for future removal surgeries.
Abstract:
A child with tricuspid atresia, concordant ventriculoarterial connections, large ventricular septal defect, and elevated pulmonary artery pressure underwent pulmonary artery banding with a polydioxanone ribbon. This procedure was successful in this patient as the ventricular septal defect became restrictive while the banding was fully absorbed after 5 months. This technique could be included in the panel of surgical strategies for patients with single ventricle physiology and potential but insufficient subpulmonary stenosis in early infancy.