A study on the mortality and complication rates following percutaneously adjustable pulmonary artery banding

Pulmonary artery (PA) banding is a procedure associated with high morbidity and mortality rates. It however can effectively palliate several forms of congenital heart lesions with increased pulmonary flow. Occasionally, to obtain an optimal degree of banding following operation, readjustment of the band is inevitable. We describe the technique of adjustable PA banding to prevent this problem.

From June 2007 to 2008, 21 patients with congenital cardiac abnormalities including Single ventricle (1), transposition of great arteries (TGA) (4) and ventricular septal defect (VSD) (16) were operated via percutaneously adjustable PA banding in Madani Hospital (Tabriz, Iran).

The mean age and the mean weight of the patients were 12±.8 months and 61±.7 kg respectively. Seventeen (81%) patients survived the operation. Cause of death was heart failure in 2 (9.5%) patients, and arrhythmia in 2 (9.5%) patients. Later, patients were followed up for 6 months. Satisfactory band gradient was achieved between 48 and 240 hours. Mean PA gradient before and 1 and 6 months after adjusting was (55.3±7.1 mmHg), (54.7±5.1 mmHg), and (53.2±5.4 mmHg) respectively. In the follow up period, there were 2 deaths, one caused by aspiration pneumonia and one caused by poor mixing. Postoperative complications were observed in 28.5% of the cases including cardiac (10%), pulmonary (pneumothorax, pneumonia) (10%) and infectious complications (9%).

The technique of percutaneously adjustable PA banding is simple and inexpensive and allows easy band adjustments without the need for multiple reoperations. Moreover, our assessment reveals that created gradient is constant and did not decrease with time.