Changing outcomes of pulmonary artery banding with the percutaneously adjustable pulmonary artery band.
BACKGROUND
Conventional pulmonary artery banding (CPAB) is associated with high morbidity and mortality. We studied the changes in outcome with the use of an adjustable pulmonary artery band (APAB).


METHODS
Between June 2001 and June 2006, 147 patients underwent PAB: 91 underwent CPAB and 56 underwent APAB.


RESULTS
The clinical profile of patients was similar in both groups. Inotropic drugs were used in 91 (100%) patients in the CPAB group and in 12 (21%) in the APAB group (p < 0.001). Early band related reoperation was required in 17 patients in the CPAB group compared with 2 patients in the APAB group (p = 0.014). There were 21 (23%) early deaths in CPAB group compared with 1 (1.8%) in the APAB group (p < 0.001). There was no difference in the intensive care unit stay, hospital stay, and final band gradients in the two groups. On a mean follow-up of 22.8 +/- 18.6 months (range, 4 to 72 months), there was PA distortion in 6 patients and band-migration in 4 patients in the CPAB group. These were not observed in the APAB group.


CONCLUSIONS
Similar band gradients were achieved with the use of conventional or adjustable PAB. However, the use of this simple and inexpensive technique of APAB was associated with a significant reduction in the early band-related deaths, need for early multiple reoperations, and early adverse acute events, thus making it a safer alternative to CPAB, more so in unstable patients.
Talwar
Sachin
S
Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India.
Choudhary
Shiv Kumar
SK
Mathur
Ankit
A
Airan
Balram
B
Singh
Rajvir
R
Juneja
Rajnish
R
Kothari
Shyam Sunder
SS
Saxena
Anita
A
D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011336:Probability; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000601:surgery*; D011652:Pulmonary Circulation / Q000502:physiology; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods