PULMONARY ARTERY BANDING IN PATIENTS WITH VENTRICULAR SEPTAL DEFECT AND SECONDARY PULMONARY HYPERTENSION: A TEN-YEAR STUDY

Abstract

Pulmonary artery banding (PA banding), part of a two stage- repair strategy popular in the 60s and 70s, is now largely reserved for critically ill infants with multiple ventricular septal defects (VSDs) or those with associated anomalies such as straddling atrioventricular valves. I Because of our limitations for total surgical correction in infants, we had to do PA banding in patients with VSD-pulmonary hypertension (PH) or VSD and atrial septal defect (ASD)-PH. <br />Consequently, we decided to report our surgical experience during a ten-year period. To assess these results, we reviewed our ten-year experience with 108 patients with the diagnosis of VSD-PH or VSD - ASD-PH who had undergone PA banding in our institution. Twenty-three of these patients, however, were excluded from the study because of a lack of information and follow-up.<br />Based on the age at which PA banding was performed, we divided patients in three groups. In the first group, there were 11(13%) patients, on whom PA-banding was performed when they were under 6 months of age. There were 38 patients (44.5%) in the second group, who had undergone PA banding when they were between 6-12 months of age. And finally, 36 (42.5%) patients made up the third group, who had had PA band performed on them when they were over one-year old. Effective PA banding was performed in 64% of Group I, 75% of Group II and 64% of Group Ill.<br />In this study, we showed that the best time for PA banding in patients with VSD-PH or VSDASD- PH in our institution is between 6-12 months of age, and that age more than one year is not an absolute contraindication for PA banding.