Lasso technique for bilateral pulmonary arterial banding

Area of Science:

• Pediatric Cardiology
• Congenital Heart Disease Surgery
• Cardiovascular Surgery

Background:

• Bilateral pulmonary artery banding (bil.PAB) is a critical palliative procedure for infants with complex heart conditions.
• The lasso technique offers a novel approach to achieving precise banding in bil.PAB.

Purpose of the Study:

• To evaluate the midterm outcomes of the lasso technique for performing bilateral pulmonary artery banding (bil.PAB).

Main Methods:

• The study involved 55 consecutive patients undergoing bil.PAB using a Gore-Tex suture lasso.
• Transesophageal echocardiography guided adjustments to achieve a 1.5 mm luminal diameter.
• Follow-up data were collected to assess outcomes.

Main Results:

• The median follow-up was 2.7 years.
• Readjustment was needed in 7 patients, all requiring further tightening.
• 20% of patients required central pulmonary artery augmentation, with only 2 cases needing surgical augmentation at the banding site.

Conclusions:

• The lasso technique for bil.PAB is technically straightforward and enables precise diameter adjustments.
• A narrower banding width appears to reduce residual stenosis and promote pulmonary artery growth.