title: Benefits of Balloon-Dilatable Bilateral Pulmonary Artery Banding in Patients With Hypoplastic Left Heart Syndrome and Other Complex Cardiac Anomalies.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the potential of balloon-dilatable bilateral pulmonary artery banding (b-PAB) and its impact on the configuration of the pulmonary artery (PA).
  
  
  BACKGROUND
  We have previously used balloon-dilatable b-PAB as first-stage palliation for patients with hypoplastic left heart syndrome (HLHS) and other complex cardiac anomalies.
  
  
  METHODS
  Two pliable tapes were placed around each branch of the PA and tightened with 7-0 polypropylene sutures in a manner that allowed for the subsequent adjustment of PA diameters. We retrospectively examined the adjustability of PA diameters by balloon dilation and the need for surgical PA angioplasty at later stages.
  
  
  RESULTS
  From January 2010 to October 2013, we performed b-PAB in 8 patients, including 3 borderline cases between biventricular repair (BVR) and univentricular repair (UVR). The b-PAB procedures were performed at a median age of 6.5 days (range, 2-10 days). Balloon dilations were performed in 10 lesions in 4 patients. All of the procedures were performed safely. Two patients reached definite BVR. The remaining 6 patients underwent open palliative procedures with univentricular physiologies that resulted in 2 deaths unrelated to the initial b-PAB. In all but 1 of the patients, the PA configuration was properly maintained and did not require surgical pulmonary angioplasty.
  
  
  CONCLUSIONS
  Balloon-dilatable b-PAB can be performed safely and prevents PA distortion at later stages. This technique should be considered for patients with complex cardiac anomalies if uncertainty exists regarding the optimal surgical strategy (BVR or UVR) in early infancy.
authors.affiliation: Department of Pediatrics, University of Yamanashi Hospital, Chuo-City, Yamanashi, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kise
authors.affiliation: Department of Surgery, University of Yamanashi Hospital, Chuo-City, Yamanashi, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Department of Pediatrics, University of Yamanashi Hospital, Chuo-City, Yamanashi, Japan.
authors.forename: Minako
authors.initials: M
authors.lastname: Hoshiai
authors.affiliation: Department of Pediatrics, University of Yamanashi Hospital, Chuo-City, Yamanashi, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Toda
authors.affiliation: Department of Pediatrics, University of Yamanashi Hospital, Chuo-City, Yamanashi, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Koizumi
authors.affiliation: Department of Pediatrics, University of Yamanashi Hospital, Chuo-City, Yamanashi, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Hasebe
authors.affiliation: Department of Pediatrics, University of Yamanashi Hospital, Chuo-City, Yamanashi, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kono
authors.affiliation: Department of Surgery, University of Yamanashi Hospital, Chuo-City, Yamanashi, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Honda
authors.affiliation: Department of Surgery, University of Yamanashi Hospital, Chuo-City, Yamanashi, Japan.
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Kaga
authors.affiliation: Department of Pediatrics, University of Yamanashi Hospital, Chuo-City, Yamanashi, Japan.
authors.forename: Kanji
authors.initials: K
authors.lastname: Sugita
mesh_terms: D000800:Angioplasty, Balloon; D005260:Female; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000150:complications / Q000401:mortality / Q000628:therapy*; D007231:Infant, Newborn; D008297:Male; D010166:Palliative Care; D011651:Pulmonary Artery / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome