title: Pulmonary artery banding for univentricular heart beyond the neonatal period.
abstract: BACKGROUND
  It is standard practice to band the pulmonary artery at 2 to 4 weeks of age in patients with univentricular hearts with increased pulmonary blood flow. The behavior of patients banded beyond the neonatal period has not been well elucidated.
  
  
  METHODS
  This was a retrospective chart review of 32 consecutive patients (one neonate) who underwent pulmonary artery banding for functionally univentricular heart. The mean age at banding was 5.7 ± 6.0 months, and 34.4% were over 6-months old.
  
  
  RESULTS
  Mortality was 15.6%. The mean systolic pulmonary artery pressure decreased from 43.6 ± 9.7 to 29.6 ± 7.0 mm Hg. The mean pre-discharge echocardiographic band gradient was 60.6 ± 13.6 mm Hg (mean systemic systolic pressure 73.7 ± 11.0 mm Hg) and systemic oxygen saturation was 81.7% ± 5.8%. At a mean follow-up period of 44.9 ± 30.0 months, 6 patients were lost to follow-up, 13 had undergone bidirectional Glenn shunt, and 7 had Fontan operations. Pulmonary artery mean pressure was 17.2 ± 4.6 mm Hg at pre-Glenn catheterization. Of the 5 patients who had not undergone further surgery, only one was inoperable. All were in functional class I or II.
  
  
  CONCLUSIONS
  Pulmonary artery banding beyond the neonatal period in suitable patients with univentricular hearts provides reasonable palliation in the intermediate term, with a significant number successfully undergoing Fontan stages.
authors.affiliation: Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Frontier Lifeline Hospital, Mogappair, Chennai, India drnavni@yahoo.com.
authors.forename: Navaneetha
authors.initials: N
authors.lastname: Sasikumar
authors.affiliation: Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Frontier Lifeline Hospital, Mogappair, Chennai, India.
authors.forename: Sowmya
authors.initials: S
authors.lastname: Ramanan
authors.affiliation: Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Frontier Lifeline Hospital, Mogappair, Chennai, India.
authors.forename: Krishna Manohar Soman
authors.initials: KM
authors.lastname: Rema
authors.affiliation: Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Frontier Lifeline Hospital, Mogappair, Chennai, India.
authors.forename: Raghavan
authors.initials: R
authors.lastname: Subramanyan
authors.affiliation: Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Frontier Lifeline Hospital, Mogappair, Chennai, India.
authors.forename: Raghavannair Suresh
authors.initials: RS
authors.lastname: Kumar
authors.affiliation: Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Frontier Lifeline Hospital, Mogappair, Chennai, India.
authors.forename: Kootturathu Mammen
authors.initials: KM
authors.lastname: Cherian
mesh_terms: D000367:Age Factors; D062186:Arterial Pressure; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D018729:Fontan Procedure; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities* / Q000503:physiopathology; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D008026:Ligation; D008297:Male; D010166:Palliative Care; D011651:Pulmonary Artery / Q000503:physiopathology / Q000601:surgery*; D011652:Pulmonary Circulation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Developing countries; Fontan procedure; banding; congenital heart defects; pulmonary artery; single ventricle