Feasibility of reversible pulmonary artery banding: early results and intermediate-term follow-up.
Development of a reversible pulmonary artery band might obviate the need for a second cardiac surgical procedure in children with some forms of congenital heart disease. We evaluated a segmented Silastic-coated Dacron mesh band 2 to 4 mm wide sewn together with absorbable 2-0 polydioxanone suture for use as a reversible pulmonary artery band. Nine puppies 6 to 8 weeks old (mean weight, 5.8 kg) underwent placement of this pulmonary artery band. All survived the operation with a mean initial systolic gradient of 6.5 +/- 1.6 mm Hg and underwent cardiac catheterization at monthly intervals for 3 months. Two puppies died of right ventricular failure. The remaining puppies underwent balloon angioplasty with balloons 20 to 25 mm in diameter. No complications resulted from balloon angioplasty, but 1 puppy died 24 hours later of unidentified causes. Balloon angioplasty decreased the mean gradient from 46.7 +/- 6.8 mm Hg to 6.7 +/- 2.6 mm Hg. Angiography showed an increase in mean diameter of the site of the pulmonary artery band from 5.2 +/- 1.0 to 10.8 +/- 1.7 mm Hg. There was no evidence of vessel injury on angiograms. Fourteen months after balloon angioplasty, the mean gradient was 22.3 +/- 17.0 mm Hg. Our data demonstrate that a functionally reversible pulmonary artery band constructed of segmented Silastic-coated Dacron mesh and 2-0 polydioxanone suture is feasible.
Epstein
M L
ML
Department of Pediatrics (Cardiology), University of Florida College of Medicine, Gainesville.
Duncan
D
D
Kanter
R J
RJ
O'Brien
D J
DJ
Alexander
J A
JA
D000800:Angioplasty, Balloon; D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D006328:Cardiac Catheterization; D004285:Dogs; D006352:Heart Ventricles; D011093:Polyethylene Terephthalates; D011651:Pulmonary Artery / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D012826:Silicone Elastomers; D013526:Surgical Mesh; D013599:Systole
D011093:Polyethylene Terephthalates; D012826:Silicone Elastomers