[Pulmonary artery banding for double inlet left ventricle]

Thirteen patients with double-inlet left ventricle who had undergone pulmonary artery banding (PAB) were reviewed. At the time of PAB, the age ranged from 2 months to 3 years. Pulmonary-systemic arterial pressure ratio and pulmonary arterial mean pressure were reduced from 0.95 +/- 0.12 to 0.4 +/- 0.18, and from 57.3 +/- 11.6 mmHg to 29.9 +/- 12.7 mmHg after PAB. Pulmonary resistance showed no statistically significant change after PAB. (from 7.6 +/- 5.2 unit to 4.8 +/- 3.9 unit) Ventricular end-diastolic volume decreased from 379.9% +/- 140.0% to 275.7% +/- 118.0% after PAB. The smallest one was 170% who successfully underwent septation procedure. Ejection fraction significantly decreased from 64.5 +/- 6.1% to 56.3 +/- 7.9%. (p less than 0.005) Ventricular end-diastolic pressure showed no significant change after PAB. (from 9.2 +/- 2.8 mmHg to 9.9 +/- 2.0 mmHg) After PAB subaortic stenosis occurred in three cases and pressure gradient were 10, 20, and 85 mmHg, respectively. Seven cases, including three cases with subaortic stenosis, underwent septation procedure and all survived. Before septation, ventricular end-diastolic volume calculated as % of normal left ventricular volume ranged from 173% to 570% and pulmonary resistance ranged from 1.6 unit to 11 unit. These data suggested that the patients with double-inlet left ventricle had efficient ventricular volume and cardiac function for septation even after PAB.