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Absorbable pulmonary artery banding: a strategy for reducing reoperations
Michael Daley1,2, Christian P Brizard1,2,3, Igor E Konstantinov1,2,3
1Department of Cardiac Surgery, The Royal Children's Hospital, Melbourne, Australia.
Summary
Absorbable polydioxanone pulmonary artery banding (PAB) effectively reduces reoperations for ventricular septal defects (VSDs). This single-stage repair approach offers a promising alternative to traditional PAB, minimizing the need for subsequent surgical interventions.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Biomaterials Science
Background:
- Pulmonary artery banding (PAB) is a surgical technique for congenital heart defects, but typically requires reoperation for removal.
- Minimizing reoperations is crucial for improving patient outcomes and reducing healthcare burdens.
Purpose of the Study:
- To evaluate the efficacy of an absorbable polydioxanone PAB in eliminating the need for reoperation.
- To assess the single-stage repair potential for congenital cardiac anomalies requiring PAB.
Main Methods:
- A cohort of 45 pediatric patients received polydioxanone absorbable PABs between 2003 and 2015.
- PAB was placed concomitantly with ventricular septal defect (VSD) closure in 62% of patients.
- Additional cardiac and aortic arch anomalies were repaired simultaneously in some patients.
Main Results:
- Hospital mortality was 1 death; 3 patients required early band removal.
- At a mean follow-up of 5.2 years, 78% of discharged patients (32/41) avoided reoperation for VSDs or PAB obstruction.
- Freedom from reoperation was 78% at 10 years, with median band resorption at 7.2 months.
Conclusions:
- Absorbable polydioxanone PAB is an effective strategy for reducing reoperations in VSD repair.
- This approach facilitates a single-stage definitive repair for certain congenital heart anomalies.
- Incorporating absorbable PABs into surgical planning for VSDs is recommended.
Keywords:
Absorbable pulmonary artery banding