title: Patent Ductus Arteriosus Banding for Circular Shunting After Pulmonary Valvuloplasty.
abstract: We report two cases of newborns with critical pulmonary stenosis having intact ventricular septum, who underwent pulmonary valve balloon valvuloplasty followed by banding of a patent ductus arteriosus. Transcatheter pulmonary valvuloplasty was performed one week after delivery. Following the procedure, both developed "circular shunting" as a consequence of left-to-right ductal flow and pulmonary regurgitation. This in turn caused increased blood flow into a dysfunctional right ventricle and low systemic cardiac output syndrome. The PDA banding was performed urgently as a rescue measure in order to restore systemic flow while still maintaining some duct-dependent pulmonary blood flow. This approach resolved the circular shunting. Outcome was favorable in both the patients.
authors.affiliation: 1 Pediatric Cardiology Department, Hospital Sant Joan de Deu-Hospital Clínic, Universitat de Barcelona, Esplugues, Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Bautista-Rodriguez
authors.affiliation: 2 Neonatology Department, Hospital Sant Joan de Deu-Hospital Clínic, Universitat de Barcelona, Esplugues, Barcelona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Rodriguez-Fanjul
authors.affiliation: 2 Neonatology Department, Hospital Sant Joan de Deu-Hospital Clínic, Universitat de Barcelona, Esplugues, Barcelona, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Moreno Hernando
authors.affiliation: 3 Pediatric Cardiology Surgery Department, Hospital Sant Joan de Deu-Hospital Clínic, Universitat de Barcelona, Esplugues, Barcelona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Mayol
authors.affiliation: 3 Pediatric Cardiology Surgery Department, Hospital Sant Joan de Deu-Hospital Clínic, Universitat de Barcelona, Esplugues, Barcelona, Spain.
authors.forename: Jose Maria
authors.initials: JM
authors.lastname: Caffarena-Calvar
mesh_terms: D063126:Balloon Valvuloplasty / Q000379:methods*; D002303:Cardiac Output, Low; D006348:Cardiac Surgical Procedures / Q000379:methods*; D004374:Ductus Arteriosus, Patent / Q000601:surgery*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008026:Ligation / Q000379:methods; D008297:Male; D011664:Pulmonary Valve / Q000601:surgery*; D011666:Pulmonary Valve Stenosis / Q000601:surgery*
keywords: emergency surgery; patent ductus arteriosus; pulmonary stenosis; shock