title: Growing potential of small aortic valve with aortic coarctation or interrupted aortic arch after bilateral pulmonary artery banding.
abstract: Bilateral pulmonary artery banding (bPAB) is utilized for some patients with a ventricular septal defect (VSD) and aortic coarctation (CoA) or interrupted aortic arch (IAA). We evaluated aortic valve (AoV) diameter and patient outcomes following bPAB.
  
  
  
  Between August 2010 and September 2015, 10 consecutive patients with VSD and patent ductus arteriosus-dependent CoA or IAA underwent bPAB because of an AoV diameter of approximately <50% of the normal value (n = 6), severe subaortic stenosis and poor patient condition (n = 1, respectively), or low birthweight (n = 2).
  
  
  
  Second-stage operations were conventional total repair in five and Damus-Kaye-Stansel anastomosis, aortic arch reconstruction and right ventricle-pulmonary artery shunt (modified Norwood) type repair in five. After modified Norwood-type repair, four patients were Yasui-type repair candidates and one was a Fontan candidate. For all patients, the mean AoV diameter increased from 3.7 ± 0.7 mm before bPAB to 4.6 ± 0.8 mm before the second-stage operation. In five patients with CoA or IAA type A, the AoV diameter significantly increased from 3.5 ± 0.3 mm to 4.5 ± 0.5 mm during the term between bPAB and the second-stage operation, with an AoV Z-score increase from -5.82 ± 0.92 to -4.28 ± 0.86. IAA type B showed a slight increase in the AoV diameter.
  
  
  
  Initial palliation with bPAB enables AoV diameter growth in some patients, improving the likelihood of conventional total repair adaptation rate, particularly for CoA or IAA type A.
authors.affiliation: Department of Pediatric Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center, Haebaru-cho, Okinawa, Japan taifuchigami@yahoo.co.jp taiworlds@yahoo.co.jp.
authors.forename: Tai
authors.initials: T
authors.lastname: Fuchigami
authors.affiliation: Department of Pediatric Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center, Haebaru-cho, Okinawa, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Nishioka
authors.affiliation: Department of Pediatric Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center, Haebaru-cho, Okinawa, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Akashige
authors.affiliation: Department of Pediatric Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center, Haebaru-cho, Okinawa, Japan.
authors.forename: Shotaro
authors.initials: S
authors.lastname: Higa
authors.affiliation: Department of Pediatric Cardiology, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center, Haebaru-cho, Okinawa, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Pediatric Cardiology, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center, Haebaru-cho, Okinawa, Japan.
authors.forename: Mami
authors.initials: M
authors.lastname: Nakayashiro
authors.affiliation: Department of Pediatric Cardiology, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center, Haebaru-cho, Okinawa, Japan.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Nabeshima
authors.affiliation: Department of Pediatric Cardiology, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center, Haebaru-cho, Okinawa, Japan.
authors.forename: Arata
authors.initials: A
authors.lastname: Sashinami
authors.affiliation: Department of Pediatric Cardiology, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center, Haebaru-cho, Okinawa, Japan.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Sakurai
authors.affiliation: Department of Pediatric Cardiology, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center, Haebaru-cho, Okinawa, Japan.
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Takefuta
authors.affiliation: Department of Pediatric Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center, Haebaru-cho, Okinawa, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Nagata
mesh_terms: D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000601:surgery; D001017:Aortic Coarctation / Q000473:pathology / Q000601:surgery*; D001021:Aortic Valve / Q000254:growth & development*; D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000601:surgery; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000601:surgery; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D011651:Pulmonary Artery / Q000601:surgery*; D012189:Retrospective Studies
keywords: Coarctation; Interrupted aortic arch; Neonate; Pulmonary artery banding; Ventricular septal defects