title: Dilatable pulmonary artery banding in infants with low birth weight or complex congenital heart disease allows avoidance or postponement of subsequent surgery.
abstract: OBJECTIVE
  This study evaluated the efficiency and feasibility of dilatable bands in selected patients.
  
  
  METHODS
  Two types of dilatable handmade bands were retrospectively evaluated and divided into two groups: main pulmonary artery bands and bilateral branch pulmonary artery bands (hybrid stage I palliation). Stepwise balloon angioplasty (BA) was performed, increasing the diameter either to completely dilate with total release of the band, or in others, to partially dilate the bands in order to improve flow and/or saturation.
  
  
  RESULTS
  Balloon angioplasty was performed in 20 patients (median birth weight 2.9 kg, range: 1.3-4.5 kg). Main pulmonary artery: Partial dilation: Six patients: Large ventricular septal defects (VSDs) and complex lesions requiring additional surgery. Progressive dilation allowed postponement of surgery in four children and allowed percutaneous VSD closure in one. Complete dilation: Eight patients: Spontaneous restriction of VSDs occurred in six patients; the bands were subsequently percutaneously completely released after a median of 39 weeks (7-91 weeks). The median gradient decreased from 90 to 38 mmHg (p<0.0001). Bilateral branch pulmonary artery: An average 8.5% increase in saturations was achieved in five patients, and in one patient, a hybrid procedure with borderline left ventricle, complete dilation allowed successful percutaneous biventricular repair.
  
  
  CONCLUSIONS
  Dilation of both main and bilateral branch pulmonary artery bands is possible, effective and safe. Dilatable main pulmonary artery bands allow for progressive dilation with postponement of surgery or complete release of the bands. Bilateral dilatable branch pulmonary bands offer palliative benefit, especially in hybrid cases where pulmonary blood flow may be limited by the bands before the ideal conditions for a stage II procedure exist.
authors.affiliation: Pediatric & Congenital Cardiology, University Hospitals Leuven, B 3000 Leuven, Belgium.
authors.forename: Stephen
authors.initials: S
authors.lastname: Brown
authors.forename: Derize
authors.initials: D
authors.lastname: Boshoff
authors.forename: Filip
authors.initials: F
authors.lastname: Rega
authors.forename: Benedicte
authors.initials: B
authors.lastname: Eyskens
authors.forename: Bart
authors.initials: B
authors.lastname: Meyns
authors.forename: Marc
authors.initials: M
authors.lastname: Gewillig
mesh_terms: D000800:Angioplasty, Balloon / Q000295:instrumentation* / Q000379:methods; D001724:Birth Weight; D004867:Equipment Design; D005240:Feasibility Studies; D006330:Heart Defects, Congenital / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D010166:Palliative Care / Q000379:methods; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome