Pulmonary artery banding: a simple procedure? A critical analysis at a tertiary center.
OBJECTIVE
Although pulmonary artery banding (PAB) seems to be a technically simple procedure it presents several peculiarities and is related to a significant morbidity and mortality. The aim of this study is to analyze the experience of a tertiary hospital on the PAB by assessing and correlating many aspects related to the procedure.


METHODS
Between January 2000 and December 2008, 61 patients undergone PAB due to congenital heart disease with increased pulmonary blood flow at Messejana Heart Hospital were assessed as for mortality, complications, stay in mechanical ventilation and need for intensive care unit (ICU), use of vasoactive drugs, difficulties in the adjustment on the banding and reoperations. Some statistical analyzes were performed to compare the subgroups.


RESULTS
In 46.8% of the patients the intended pressoric adjustment was not achieved and in 6.5% it was necessary another surgery to readjust the banding. The mean time of mechanical ventilation was 14.1+/-49.6 days and ICU 14.16+/-10.92 days. In 82.6% of the patients vasoactives drugs were administrated for 10.3+/-12.79 days. Severe complications were noted in 49.15% of patients and cardiac insufficiency was the most common one with an incidence of 44%. The mortality rate was 8.2% and it was not influenced by weight or associated procedures with the PAB neither if univentricular or biventricular heart disease.


CONCLUSIONS
The PAB can be performed with acceptable mortality rates compatible with the ones of the world literature. Nevertheless, the adjustment of the banding is difficult to be assessed during the surgery by making the procedure complex and justifying the high incidence of complications and long stay in ICU. It wasn't found any specific risk factor significant to mortality neither uni- or biventricular heart disease.
Valente
Acrisio Sales
AS
Hospital do Coração de Messejana, CE, Brazil. acrisiovalente@yahoo.com
Mesquita
Fernando
F
Mejia
Juan Alberto Cosquillo
JA
Maia
Isabel Cristina Leite
IC
Maior
Márcia Souto
MS
Branco
Klébia Castelo
KC
Pinto
Valdester Cavalcante
VC
Carvalho
Waldemiro
W
D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D016009:Chi-Square Distribution; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011651:Pulmonary Artery / Q000601:surgery*