A novel adjustable pulmonary artery banding system for hypoplastic left heart syndrome.
OBJECTIVE
We describe the first case in which a neonate with hypoplastic left heart syndrome was initially managed using a mini adjustable banding system.


METHODS
Through a mid-sternotomy, a 5-day-old neonate underwent bilateral pulmonary artery banding using this new system, combined with placement of a main pulmonary artery to the innominate artery shunt.


RESULTS
The patient had an uneventful postoperative course. Three percutaneous adjustments of the banding system were necessary to keep the arterial oxygen saturation in the 75% to 85% range. On day 48 of life, she was submitted to stent placement (6 mm) within the atrial septum to treat a restrictive atrial septal defect. Afterward, seven additional percutaneous adjustments of the banding system were necessary. The Norwood operation and the bidirectional Glenn shunt were carried out on the day 106 of life. The bands were removed with no pulmonary artery distortion.


CONCLUSIONS
The clinical use of this innovative pulmonary artery banding system was feasible, safe, and effective. This allowed for customization of the pulmonary blood flow according to the underlying clinical needs, resulting in a more precise balance between the pulmonary and systemic circulations.
Assad
Renato S
RS
Hospital Samaritano, São Paulo, Brazil. rsassad@cardiol.br
Zamith
Marina M
MM
Silva
Maria Fernanda
MF
Thomaz
Petrônio G
PG
Miana
Leonardo A
LA
Guerra
Vitor C
VC
Pedra
Carlos A
CA
Marcial
Miguel B
MB
D006348:Cardiac Surgical Procedures / Q000295:instrumentation*; D005260:Female; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000503:physiopathology / Q000601:surgery*; D007231:Infant, Newborn; D010166:Palliative Care; D011651:Pulmonary Artery / Q000601:surgery*; D011652:Pulmonary Circulation