Balloon dilatation of pulmonary artery banding: Norwegian experience over more than 20 years.
OBJECTIVE
The purpose of this paper was to present the results of a simple modification of the suture technique for pulmonary artery banding (PAB), which allows for stepwise debanding by use of balloon catheter.


RESULTS
During the period 1985-2007, PAB operations were performed in 227 children at Rikshospitalet. Of these children, 14.5% (n = 33) were treated by balloon dilatation of the PAB. Nine were treated twice. The intention of the procedure was total debanding in 17 and palliative treatment by stepwise dilatation of the PAB in 16 patients. Median follow up time was 59 months. The mean reduction of the gradient was more pronounced in the first group (37.0 ± 19.0 vs. 14.5 ± 10.3 mmHg, P < 0.001). The average mean oxygen saturation improved, however, significantly within the palliated group. The median time for reintervention after stepwise dilatation was 9 months. Serious, procedure-related complications occurred in 2 of 42 catheterizations (4.8%). Debanding by catheter replaced surgery in 8 of the 17 patients (47%).


CONCLUSIONS
We consider catheter debanding a valuable alternative in selected cases. Combination with additional interventional techniques may extend the future indications.
Holmström
Henrik
H
Department of Pediatrics, Rikshospitalet (National Hospital), 0027, Oslo, Norway. henrik.holmstrom@rikshospitalet.no
Bjørnstad
Per G
PG
Smevik
Bjarne
B
Lindberg
Harald
H
D000465:Algorithms; D002404:Catheterization / Q000379:methods* / Q000706:statistics & numerical data; D002648:Child; D006330:Heart Defects, Congenital / Q000628:therapy*; D006801:Humans; D009664:Norway; D010166:Palliative Care / Q000379:methods; D011651:Pulmonary Artery; D013536:Suture Techniques