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Feasibility and related outcome of intraluminal pulmonary artery banding.
Eur J Cardiothorac Surg 2015; 48(3):470-80EJ

Abstract

OBJECTIVES

This retrospective study evaluated the feasibility and related outcome of intraluminal pulmonary artery banding (I-PAB).

METHODS

Thirty-two children underwent I-PAB between July 2006 and April 2014. The median age and weight were 60 days (range: 5 days to 4.2 years) and 3.7 kg (range: 2.6-13.0 kg), respectively. Cardiac diagnoses included single ventricle morphology (n = 11), complex ventricular septal defects (n = 11), balanced atrioventricular septal defects (n = 3), congenitally corrected transposition of the great arteries (n = 2) and aortic arch hypoplasia with ventricular septal defects (n = 5). On cardiopulmonary bypass (CPB), 2 I-PAB modifications with either 1 (n = 24) or 2 ('hour-glass-technique', n = 8) fenestrated pericardial patches were performed.

RESULTS

The median fenestration size was 5 mm (range: 4-6.5 mm). In 18 patients I-PAB was a solitary procedure; in 3 of them the decision was made intraoperatively. There was no hospital mortality. The median interval to debanding was 189 days (range: 112 days to 2.6 years). During this period, we observed a significant increase in the pressure gradient over I-PAB (P < 0.01), whereas arterial saturations remained stable. Four patients received balloon dilatation of I-PAB to prolong the palliation period. No patient experienced band occlusion, pulmonary hypertension related to I-PAB, coronary or pulmonary valve impairment. Debanding was performed in 27 patients and one of them required pulmonary patch arterioplasty due to I-PAB-associated pulmonary trunk distortion. Three patients are still awaiting further surgery. There were 2 late deaths prior to, and 3 after debanding, all not related to I-PAB.

CONCLUSIONS

I-PAB with an exactly defined internal orifice is feasible and effective. Although arterial saturations seem to remain stable, balloon dilatation of I-PAB can be performed safely and efficiently in order to prolong the palliation period. The rate of I-PAB-related complications is low, which might improve the long-term patient outcome. Therefore, despite requiring CPB, I-PAB is our institutional preference for children who require pulmonary artery banding.

Authors+Show Affiliations

Department of Pediatric Cardiac Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany stany.sandrio@uk-erlangen.de s.p.sandrio@googlemail.com.Department of Pediatric Cardiac Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.Department of Pediatric Cardiology, University Heart Center Hamburg, Hamburg, Germany.Department of Pediatric Cardiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.Department of Pediatric Cardiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.Department of Pediatric Cardiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.Department of Pediatric Cardiac Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.Department of Pediatric Cardiac Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25515337

Citation

Sandrio, Stany, et al. "Feasibility and Related Outcome of Intraluminal Pulmonary Artery Banding." European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, vol. 48, no. 3, 2015, pp. 470-80.
Sandrio S, Purbojo A, Arndt F, et al. Feasibility and related outcome of intraluminal pulmonary artery banding. Eur J Cardiothorac Surg. 2015;48(3):470-80.
Sandrio, S., Purbojo, A., Arndt, F., Toka, O., Glöckler, M., Dittrich, S., ... Rüffer, A. (2015). Feasibility and related outcome of intraluminal pulmonary artery banding. European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, 48(3), pp. 470-80. doi:10.1093/ejcts/ezu464.
Sandrio S, et al. Feasibility and Related Outcome of Intraluminal Pulmonary Artery Banding. Eur J Cardiothorac Surg. 2015;48(3):470-80. PubMed PMID: 25515337.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Feasibility and related outcome of intraluminal pulmonary artery banding. AU - Sandrio,Stany, AU - Purbojo,Ariawan, AU - Arndt,Florian, AU - Toka,Okan, AU - Glöckler,Martin, AU - Dittrich,Sven, AU - Cesnjevar,Robert, AU - Rüffer,André, Y1 - 2014/12/16/ PY - 2014/08/30/received PY - 2014/11/03/accepted PY - 2014/12/18/entrez PY - 2014/12/18/pubmed PY - 2016/6/4/medline KW - Cardiopulmonary bypass KW - Paediatric KW - Pulmonary artery banding SP - 470 EP - 80 JF - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JO - Eur J Cardiothorac Surg VL - 48 IS - 3 N2 - OBJECTIVES: This retrospective study evaluated the feasibility and related outcome of intraluminal pulmonary artery banding (I-PAB). METHODS: Thirty-two children underwent I-PAB between July 2006 and April 2014. The median age and weight were 60 days (range: 5 days to 4.2 years) and 3.7 kg (range: 2.6-13.0 kg), respectively. Cardiac diagnoses included single ventricle morphology (n = 11), complex ventricular septal defects (n = 11), balanced atrioventricular septal defects (n = 3), congenitally corrected transposition of the great arteries (n = 2) and aortic arch hypoplasia with ventricular septal defects (n = 5). On cardiopulmonary bypass (CPB), 2 I-PAB modifications with either 1 (n = 24) or 2 ('hour-glass-technique', n = 8) fenestrated pericardial patches were performed. RESULTS: The median fenestration size was 5 mm (range: 4-6.5 mm). In 18 patients I-PAB was a solitary procedure; in 3 of them the decision was made intraoperatively. There was no hospital mortality. The median interval to debanding was 189 days (range: 112 days to 2.6 years). During this period, we observed a significant increase in the pressure gradient over I-PAB (P < 0.01), whereas arterial saturations remained stable. Four patients received balloon dilatation of I-PAB to prolong the palliation period. No patient experienced band occlusion, pulmonary hypertension related to I-PAB, coronary or pulmonary valve impairment. Debanding was performed in 27 patients and one of them required pulmonary patch arterioplasty due to I-PAB-associated pulmonary trunk distortion. Three patients are still awaiting further surgery. There were 2 late deaths prior to, and 3 after debanding, all not related to I-PAB. CONCLUSIONS: I-PAB with an exactly defined internal orifice is feasible and effective. Although arterial saturations seem to remain stable, balloon dilatation of I-PAB can be performed safely and efficiently in order to prolong the palliation period. The rate of I-PAB-related complications is low, which might improve the long-term patient outcome. Therefore, despite requiring CPB, I-PAB is our institutional preference for children who require pulmonary artery banding. SN - 1873-734X UR - https://www.unboundmedicine.com/medline/citation/25515337/Feasibility_and_related_outcome_of_intraluminal_pulmonary_artery_banding_ L2 - https://academic.oup.com/ejcts/article-lookup/doi/10.1093/ejcts/ezu464 DB - PRIME DP - Unbound Medicine ER -