Upper mini sternotomy approach for pulmonary artery banding: A single centre experience

Area of Science:

• Pediatric Cardiac Surgery
• Thoracic Surgery Techniques

Background:

• Pulmonary artery banding (PAB) is a key cardiac surgery procedure.
• Established surgical approaches include left lateral thoracotomy, median sternotomy, and left anterior thoracotomy.
• Limited data exists on the upper mini sternotomy approach for PAB.

Purpose of the Study:

• To evaluate the safety and outcomes of the upper mini sternotomy approach for PAB.
• To assess the impact of this approach on facilitating subsequent redo surgeries.

Main Methods:

• Retrospective study of 22 patients undergoing PAB via upper mini sternotomy.
• Indications included complete atrioventricular septal defect, multiple muscular ventricular septal defects, and univentricular heart with increased pulmonary blood flow.
• Data collected on patient demographics, surgical parameters, and outcomes.

Main Results:

• Median age at PAB was 2.0 months, median weight 3.1 kg.
• Surgery time ranged from 75-135 minutes, with a peak gradient of 54-78 mmHg.
• One non-surgical mortality (4.5%); 15 patients had redo surgery with no mortality or sternotomy complications. Reopening time for redo surgery was 17-32 minutes.

Conclusions:

• The upper mini sternotomy approach for PAB is safe.
• This approach facilitates subsequent redo surgery.
• It represents a valuable alternative to conventional surgical methods.