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Pulmonary artery banding in the current era: Is it still useful?
Maziar Gholampour Dehaki1, Ali Sadeghpour Tabaee, Changiz Azadi Ahmadabadi
1Department of Cardiovascular Surgery, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Pulmonary artery banding is effective for congenital heart defects with pulmonary hypertension. This procedure is safe, with low mortality, and remains a valuable treatment option for infants with complex medical issues.
Area of Science:
- Cardiology
- Pediatric Surgery
Background:
- Pulmonary artery (PA) banding is a palliative procedure for congenital heart defects (CHD) with pulmonary hypertension (PH).
- Assessing the current efficacy and safety of PA banding is crucial for clinical decision-making.
Purpose of the Study:
- To evaluate the outcomes of PA banding in patients with CHD and PH.
- To compare different methods of PA banding application.
Main Methods:
- Retrospective analysis of 305 patients undergoing PA banding (2005-2010).
- Patients were grouped by banding criteria: Trusler's rule (20%), PA pressure (55%), and surgeon experience (25%).
- Follow-up averaged 39 months, with 75% undergoing definitive repair.
Main Results:
- High rates of anatomical (97%) and functional (92%) effectiveness were observed across all groups.
- No significant differences in efficacy were found between banding methods (P > 0.7).
- Low incidence of PA bifurcation stenosis (2%) and pulmonary valve injury (0.3%); mortality was 2% for banding and 3% for definitive repair.
Conclusions:
- PA banding remains a safe and effective option for managing infants with CHD and PH, especially those with comorbidities.
- The procedure demonstrates low morbidity and mortality, supporting its continued role in pediatric cardiac surgery.
Background:
The objective of this study was to assess the results of the pulmonary artery (PA) banding in patients with congenital heart defects (CHD) and pulmonary hypertension (PH) in the current era.
Methods:
We analyzed data from 305 patients who underwent PA banding between April 2005 and April 2010 at our centre. All patients were approached through a left thoracotomy. Twenty percent of patients underwent PA banding based on Trusler's rule (Group 1), 55% of them underwent PA banding based on PA pressure measurement (Group 2), and the rest of them (25%) based on surgeon experience (Group 3). The follow-up period was 39 ± 20 month and 75% of patients (230 cases) had definitive repair at mean interval 23 ± 10 months.
Results:
The rate of anatomically and functionally effectiveness of PA banding in all groups was high (97% and 92%, respectively). There were no significant differences in anatomically and functionally efficacy rate between all groups (P=0.77, P=0.728, respectively). There was PA bifurcation stenosis in six cases (2%), and pulmonary valve injury in one case (0.3%). The mortality rate in PA banding was 2% and in definitive repair was 3%.
Conclusions:
We believe that PA banding still plays a role in management of patients with CHD, particularly for infants with medical problems such as sepsis, low body weight, intracranial hemorrhage and associated non cardiac anomalies. PA banding can be done safely with low morbidity and mortality.
