Pulmonary artery banding for truncus arteriosus in the first year of life

Area of Science:

• Pediatric Cardiology
• Congenital Heart Disease Surgery

Background:

• Truncus arteriosus (TA) is a complex congenital heart defect.
• Infantile outcomes for TA historically showed high mortality.

Purpose of the Study:

• To review outcomes of pulmonary artery banding (PAB) for infantile TA.
• To evaluate the shift towards early complete correction for TA.

Main Methods:

• Retrospective review of 15 infants undergoing PAB for TA between 1957-1974.
• Analysis of mortality and survival data.
• Comparison with outcomes after adoption of early complete correction policy in 1974.

Main Results:

• Pulmonary artery banding (PAB) for truncus arteriosus (TA) in infancy resulted in a 73% mortality rate (10 hospital, 1 late death).
• Following a policy change in 1974, four infants with TA and one with hemitruncus underwent complete correction.
• Three of these infants survived, with follow-up durations of 22, 17, and 9 months post-operation.

Conclusions:

• Pulmonary artery banding (PAB) in infancy for truncus arteriosus (TA) is associated with high mortality.
• Early complete correction has been adopted as the primary treatment strategy for severely symptomatic infants with TA since 1974.
• Initial survival data for early complete correction suggest improved outcomes compared to PAB.