Balloon debanding the pulmonary artery: in vitro studies and early clinical experience

Despite increasing corrective procedures for children with congenital heart disease, there remains a place for surgical banding of the main pulmonary artery (PA). In the vast majority of cases, these bands eventually need to be removed. We examined three cases of percutaneous disruption of PA bands using balloon catheters at our institution. We also performed an in vitro study of PA band disruption mechanism and disruption pressure. Our in vitro study suggested a predictable burst pressure for PA bands over the range of diameters routinely used in pediatric practice. Of three patients who underwent interventional debanding, two patients had successful disruption of their PA bands with no reintervention at 19 months and 23 months follow up. Balloon disruption of surgical PA bands may offer a less invasive alternative to surgical band removal. In vitro analysis suggests that the burst pressure required and mechanism of disruption are predictable.