title: Efficacy and safety of percutaneous transluminal balloon dilation to prevent progression of banding site stenosis after bilateral pulmonary artery banding.
abstract: OBJECTIVE
  To investigate the efficacy and safety of percutaneous transluminal balloon dilation (PTBD) for the treatment of bilateral pulmonary artery banding (bil-PAB) site stenosis.
  
  
  BACKGROUND
  Although bil-PAB is an alternative initial treatment for high-risk neonates with hypoplastic left heart syndrome (HLHS) or critical aortic stenosis (cAS), those patients often suffer from desaturation because of progressive stenosis of the bil-PAB sites during the interstage period.
  
  
  METHODS
  We retrospectively evaluated the efficacy and safety of 11 consecutive PTBD procedures performed between 2006 and 2012 to treat bil-PAB site stenosis in four high-risk infants (three females) with HLHS or cAS.
  
  
  RESULTS
  PTBD was repeated twice in two patients and three times in one patient over intervals. The mean balloon diameter (BD) and BD-to-band circumference (BC) ratio were 3.1 ± 0.5 mm and 0.31 ± 0.06, respectively. After the procedures, the mean minimum lumen diameter was dilated significantly from 1.1 ± 0.1 mm to 1.7 ± 0.3 mm (P < 0.01), and the mean peripheral oxygen saturation increased significantly from 75 ± 8% to 85 ± 4% (P < 0.01). All patients reached the next stage operation involving the Norwood & bidirectional Glenn or Ross procedure, after growth. No complications such as band rupture occurred.
  
  
  CONCLUSIONS
  For progressive stenosis of bil-PAB sites, PTBD using a balloon size that did not exceed the BC (BD around 30% of the BC) was an effective and safe procedure.
authors: Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors: Shinsuke
authors: S
authors: Hoshino
authors: Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors: Masataka
authors: M
authors: Kitano
authors: Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors: Tadaaki
authors: T
authors: Abe
authors: Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors: Satoshi
authors: S
authors: Yazaki
authors: Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors: Koji
authors: K
authors: Kagisaki
mesh_terms: D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D003251:Constriction, Pathologic; D018450:Disease Progression; D004867:Equipment Design; D005260:Female; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D007231:Infant, Newborn; D008297:Male; D058327:Norwood Procedures / Q000009:adverse effects*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D062666:Vascular Access Devices
keywords: Norwood procedure; Ross procedure; bidirectional Glenn procedure; critical aortic stenosis; hypoplastic left heart syndrome