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Pulmonary artery banding revisited
I L Kron1, S P Nolan, T L Flanagan
1Department of Surgery, University of Virginia Health Sciences Center, Charlottesville 22908.
Annals of Surgery
|May 1, 1989
Summary
Pulmonary artery (PA) banding is effective for infants with congenital heart disease, especially single ventricle defects. This procedure shows a 12% 30-day mortality for single ventricle patients, with 92% 10-year survival.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease Surgery
- Cardiovascular Interventions
Background:
- Pulmonary artery (PA) banding, introduced in 1952, is a palliative surgical procedure.
- It aims to reduce excessive pulmonary blood flow in complex congenital heart conditions.
- The study reviews outcomes of PA banding performed between 1955 and 1988.
Purpose of the Study:
- To evaluate the long-term outcomes and mortality rates of PA banding in pediatric patients.
- To assess the efficacy of PA banding across different preoperative diagnoses.
- To determine the current role of PA banding in managing congenital heart disease.
Main Methods:
- Retrospective review of 170 children undergoing PA banding at the University of Virginia Medical Center.
- Analysis of patient outcomes stratified by preoperative diagnoses.
- Calculation of 30-day and late mortality rates, and actuarial survival.
Main Results:
- Overall late mortality was approximately 10% (1% per year).
- Children with single ventricle defects had a significantly lower 30-day mortality (12%) compared to other diagnoses (30%, p<0.05).
- Actuarial survival at 10 years for single ventricle patients was 92%.
Conclusions:
- PA banding remains a valuable intervention for specific congenital heart diseases, particularly in infants with single ventricle physiology.
- The indication for PA banding in single ventricle infants aligns with historical recommendations.
- Improved surgical techniques and early correction have reduced the overall use of PA banding but not eliminated its critical role.