Top

General Thoracic and Cardiovascular Surgery

Published in:

01-06-2013 | Original Article

Flow-adjustable bilateral pulmonary artery banding in the neonatal period for severe congenital heart diseases

Authors: Akihiro Yoshimoto, Takashi Miyamoto, Shinichi Ozaki, Tohru Kobayashi, Tomio Kobayashi

Published in: General Thoracic and Cardiovascular Surgery | Issue 6/2013

Abstract

Objective

We perform bilateral pulmonary artery banding (BPAB) combined with postoperative percutaneous pulmonary artery balloon dilatation (PABD) as stage I palliation for severe congenital heart diseases. The objective of this study was to evaluate the efficacy of our management strategy for the treatment of severe congenital heart diseases.

Methods

From October 2007 to March 2010, 9 consecutive patients underwent BPAB. Subsequently, all patients had a second-stage operation; we performed biventricular repair for 3 cases and univentricular repair for 6 cases. Clinical data were obtained by retrospectively reviewing medical records.

Results

There was no early mortality (30 days). After the neonatal period, we controlled the pulmonary blood flow to be slightly elevated by PABD. Therefore, the Qp/Qs level was around 1.0, which might contribute to achieving good pulmonary artery growth and avoid intraoperative pulmonary arterioplasty. Except for one patient, intraoperative pulmonary arterioplasty in the second-stage operation was not necessary. Regarding Norwood procedure, an 8 mm RV-PA (right ventricle-pulmonary artery) conduit was available for respective patients.

Conclusions

Although further studies are warranted, our strategy might prove to be a valid clinical option for the treatment of severe congenital heart diseases.

Bacha EA, Daves S, Hardin J, Abdulla RI, Anderson J, Kahana M, et al. Single-ventricle palliation for high-risk neonates: the emergence of an alternative hybrid stage I strategy. J Thorac Cardiovasc Surg. 2006;131:163–71.PubMedCrossRef

Talwar S, Choudhary SK, Mathur A, Airan B, Singh R, Juneja R, et al. Changing outcomes of pulmonary artery banding with the percutaneously adjustable pulmonary artery band. Ann Thorac Surg. 2008;85:593–8.PubMedCrossRef

Locker C, Dearani JA, O’Leary PW, Puga FJ. Endoluminal pulmonary artery banding: technique, applications and results. Ann Thorac Surg. 2008;86:588–95.PubMedCrossRef

Corno AF, Prosi M, Fridez P, Zunino P, Quarteroni A, von Segesser LK, et al. The non-circular shape of FloWatch-PAB prevents the need for pulmonary artery reconstruction after banding. Computational fluid dynamics and clinical correlations. Eur J Cardiothorac Surg. 2006;29:93–9.PubMedCrossRef

Assad RS, Zamith MM, Silva MF, Thomaz PG, Miana LA, Guerra VC, et al. A novel adjustable pulmonary artery banding system for hypoplastic left heart syndrome. Ann Thorac Surg. 2007;84:2081–4.PubMedCrossRef

Bonnet D, Sidi D, Vouhe PR. Absorbable pulmonary artery banding in tricuspid atresia. Ann Thorac Surg. 2001;71:360–1.PubMedCrossRef

Brown S, Boshoff D, Rega F, Eyskens B, Meyns B, Gewillig M. Dilatable pulmonary artery banding in infants with low birth weight or complex congenital heart disease allows avoidance or postponement of subsequent surgery. Eur J Cardiothorac Surg. 2010;37:296–301.PubMed

Kern JH, Hinton VJ, Nereo NE, Hayes CJ, Gersony WM. Early developmental outcome after the Norwood procedure for hypoplastic left heart syndrome. Pediatrics. 1998;102:1148–52.PubMedCrossRef

Tsui SS, Schultz JM, Shen I, Ungerleider RM. Postoperative hypoxemia exacerbates potential brain injury after deep hypothermic circulatory arrest. Ann Thorac Surg. 2004;78:188–96.PubMedCrossRef

10.

Caldarone CA, Honjo O, Benson LN, Van Arsdell GS. Modification of stage II procedure after hybrid palliation (bilateral pulmonary artery banding and ductal stenting) for hypoplastic left-sided heart syndrome: modified arch reconstruction with retained stented ductus patch. J Thorac Cardiovasc Surg. 2007;134:1588–9.PubMedCrossRef

11.

Sakurai T, Kado H, Nakano T, Hinokiyama K, Shiose A, Kajimoto M, et al. Early results of bilateral pulmonary artery banding for hypoplastic left heart syndrome. Eur J Cardiothorac Surg. 2009;36:973–9.PubMedCrossRef

12.

Mitani Y, Takabayashi S, Sawada H, Ohashi H, Hayakawa H, Ikeyama Y, et al. Fate of the “opened” arterial duct: lessons learned from bilateral pulmonary artery banding for hypoplastic left heart syndrome under the continuous infusion of prostaglandin E1. J Thorac Cardiovasc Surg. 2007;133:1653–4.PubMedCrossRef

13.

Kobayashi T, Miyamoto T, Kobayashi T, Ikeda K, Koizuka K, Okamoto H, et al. Staged repair of truncus arteriosus with interrupted aortic arch: adjustable pulmonary artery banding. Ann Thorac Surg. 2010;89:973–5.PubMedCrossRef

14.

Hsia Tain-Yen, Gruber Peter J. Factors influencing neurologic outcome after neonatal cardiopulmonary bypass: what we can and cannot control. Ann Thorac Surg. 2006;81:2381–8.CrossRef

15.

Knirsch Walter, Liamlahi Rabia, Hug Maja I, Hoop Ricarda, von Rhein Michael, Pretre Rene, Kretschmar Oliver, Latal Beatrice. Mortality and neurodevelopmental outcome at 1 year of age comparing hybrid and Norwood procedures. Eur J Cardiothorac Surg. 2012;42:33–9.PubMedCrossRef

Title: Flow-adjustable bilateral pulmonary artery banding in the neonatal period for severe congenital heart diseases
Authors: Akihiro Yoshimoto
Takashi Miyamoto
Shinichi Ozaki
Tohru Kobayashi
Tomio Kobayashi
Publication date: 01-06-2013
Publisher: Springer Japan
Published in: General Thoracic and Cardiovascular Surgery / Issue 6/2013
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-013-0221-9

At a glance: The STEP trials

Springer Medicine

Flow-adjustable bilateral pulmonary artery banding in the neonatal period for severe congenital heart diseases

Abstract

Objective

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2013

Selection of artificial valve for the patients on hemodialysis

Resection of a giant cardiac hemangioma

Medical teleconferencing with high-definition video presentation on the ‘usual’ Internet

Successful management of intractable chylothorax in Gorham–Stout disease by awake thoracoscopic surgery

A safe and rapid direct true lumen cannulation for acute type A aortic dissection

Shaggy and calcified aorta: surgical implications