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Pulmonary artery band migration producing endobronchial obstruction
R L Parry1, S Gordon, N J Sherman
1Division of Pediatric Surgery, Children's Hospital Los Angeles, CA, USA.
Journal of Pediatric Surgery
|January 1, 1997
Summary
Pulmonary artery banding in infants can migrate, causing rare but severe complications. A band migrated into the tracheobronchial tree, leading to lobe destruction years after surgery.
Area of Science:
- Pediatric Cardiology
- Thoracic Surgery
- Pulmonary Medicine
Background:
- Pulmonary artery banding (PAB) is a palliative procedure to reduce excessive pulmonary blood flow in infants with congenital heart defects.
- While generally safe, PAB carries risks, including rare instances of band migration and erosion through the pulmonary artery.
Observation:
- A patient developed bronchiectasis and destruction of the right middle and lower lobes five years post-PAB and corrective cardiac surgery.
- Post-lobectomy respiratory distress led to bronchoscopy, revealing the original PAB within the tracheobronchial tree.
Findings:
- The identified pulmonary artery band had migrated from its original position.
- The migrated band is hypothesized to have caused tracheobronchial obstruction, leading to distal lung destruction.
Implications:
- This case highlights a rare but serious delayed complication of pulmonary artery banding.
- Pediatric surgeons and cardiologists should maintain awareness of potential band migration, even years after initial surgery, in patients with respiratory symptoms.