title: Treatment of elevated pulmonary artery pressure in a child after Glenn procedure: transcatheter closure of pulmonary artery banding with subsequent sildenafil therapy.
abstract: An additional source of pulmonary blood flow in a patient with bidirectional Glenn procedure (BGD) may cause elevation of  mean pulmonary artery pressure (MPAP), precluding safe completion of the Fontan operation. We present a case of single  ventricle physiology after pulmonary artery banding (PAB) and Glenn procedure. At the age of six years, cardiac catheterisation  revealed in the patient elevated MPAP (22 mm Hg). The PAB was closed through the right internal jugular vein with an  Amplatzer Atrial Septal Occluder. After the procedure, MPAP remained at a similar level. Sildenafil oral therapy was applied  for six months. Subsequent heart catheterisation confirmed complete closure of PAB and decrease of MPAP to 10 mm Hg.  The abovementioned complex treatment of elevated MPAP pressure in a child after Glenn therapy allowed safe completion  of the Fontan operation.
authors.affiliation: Department of Congenital Heart Diseases and Paediatric Cardiology, Medical University of Silesia, Zabrze, Poland.
authors.forename: Jose Pascual Salas
authors.initials: JP
authors.lastname: Llamas
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Szkutnik
authors.forename: Roland
authors.initials: R
authors.lastname: Fiszer
authors.forename: Jacek
authors.initials: J
authors.lastname: Białkowski
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D002648:Child; D018729:Fontan Procedure / Q000379:methods*; D006325:Heart Atria / Q000601:surgery; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D010879:Piperazines / Q000627:therapeutic use*; D011651:Pulmonary Artery / Q000601:surgery; D011687:Purines / Q000627:therapeutic use; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate