A percutaneously adjustable device for banding of the pulmonary trunk

An optimal result is often difficult to obtain with conventional banding of the pulmonary trunk. Furthermore, this procedure has a significant surgical morbidity and mortality. An inflatable device has therefore been developed which consists of an inflatable band and a valve. The band is made of a silicone balloon which is covered with reinforced braid. The band is applied loosely around the pulmonary trunk through a left lateral thoracotomy. The valve is implanted subcutaneously in an intercostal space. The size of the band can be adjusted postoperatively using a needle and fluid-filled syringe percutaneously to inflate or deflate the balloon. Experiments were conducted in 5 animals and follow-up evaluation by cardiac catheterization and angiocardiography was made up to 4 months after implantation of the device. The band could be effectively and reliably adjusted and no malfunction or complication occurred. This preliminary study suggests that this new technique may make banding of the pulmonary trunk a more reliable and effective procedure and may reduce surgical morbidity and mortality. It also may avoid or delay subsequent additional surgery for revision of a band which is too tight or too loose.