title: Unexpected Internalization of a Pulmonary Artery Band in a Porcine Model of Tetralogy of Fallot.
abstract: We report our experience of an unexpected complication of internalization of a pulmonary artery (PA) band in the vascular lumen, which occurred in a chronic porcine model of repaired tetralogy of Fallot (TOF).
  
  
  
  Twelve piglets were divided into 3 groups: (1) TOF model animals (PA band plus pulmonary valvotomy, n = 4), (2) pulmonary insufficiency (PI) animals (pulmonary valvotomy, n = 4), and (3) control animals (n = 4). A nonabsorbable, coated braided polyester tape was used to perform the main pulmonary artery banding. Echocardiography was performed 4 months postoperatively. After each animal was euthanized, PA histological analysis was performed in animals with band internalization.
  
  
  
  Significant postsurgical pulmonary regurgitation and right ventricular enlargement were present in the TOF and PI, compared with control animals, whereas no significant pulmonary stenosis was observed in TOF animals when compared with PI group. Postmortem examination of all TOF animals revealed the constricting band to be intact but partially internalized into the PA lumen, allowing blood flow around the stenosis. Histological sections of the banded PA in the area of internalization showed a significant disorganization of the medial layer, with significant scarring and fibrotic reaction surrounding the outside of the band and the presence of inflammatory cells suggesting a significant inflammatory response during band internalization.
  
  
  
  Band internalization may occur after PA banding using a nonabsorbable, coated braided polyester tape in a chronic porcine model of repaired TOF. This unusual complication was likely due to the type of material used for banding.
authors.affiliation: 1 Department of Paediatric and Adult Congenital Heart defects, University Hospital of Bordeaux, Bordeaux, France.|2 L'Institut de Rythmologie et Modélisation Cardiaque (LIRYC), Université de Bordeaux, Bordeaux, France.|3 Inserm U1045 CRCTB, Université de Bordeaux, Bordeaux, France.
authors.forename: Zakaria
authors.initials: Z
authors.lastname: Jalal
authors.affiliation: 1 Department of Paediatric and Adult Congenital Heart defects, University Hospital of Bordeaux, Bordeaux, France.|2 L'Institut de Rythmologie et Modélisation Cardiaque (LIRYC), Université de Bordeaux, Bordeaux, France.|3 Inserm U1045 CRCTB, Université de Bordeaux, Bordeaux, France.
authors.forename: François
authors.initials: F
authors.lastname: Roubertie
authors.affiliation: 1 Department of Paediatric and Adult Congenital Heart defects, University Hospital of Bordeaux, Bordeaux, France.|2 L'Institut de Rythmologie et Modélisation Cardiaque (LIRYC), Université de Bordeaux, Bordeaux, France.|3 Inserm U1045 CRCTB, Université de Bordeaux, Bordeaux, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Fournier
authors.affiliation: 2 L'Institut de Rythmologie et Modélisation Cardiaque (LIRYC), Université de Bordeaux, Bordeaux, France.|3 Inserm U1045 CRCTB, Université de Bordeaux, Bordeaux, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Dubes
authors.affiliation: 2 L'Institut de Rythmologie et Modélisation Cardiaque (LIRYC), Université de Bordeaux, Bordeaux, France.|3 Inserm U1045 CRCTB, Université de Bordeaux, Bordeaux, France.
authors.forename: David
authors.initials: D
authors.lastname: Benoist
authors.affiliation: 2 L'Institut de Rythmologie et Modélisation Cardiaque (LIRYC), Université de Bordeaux, Bordeaux, France.|3 Inserm U1045 CRCTB, Université de Bordeaux, Bordeaux, France.
authors.forename: Jerome
authors.initials: J
authors.lastname: Naulin
authors.affiliation: 4 University Hospital of Bordeaux, Bordeaux, France.
authors.forename: Samantha
authors.initials: S
authors.lastname: Delmond
authors.affiliation: 4 University Hospital of Bordeaux, Bordeaux, France.
authors.forename: Marlène
authors.initials: M
authors.lastname: Durand
authors.affiliation: 1 Department of Paediatric and Adult Congenital Heart defects, University Hospital of Bordeaux, Bordeaux, France.|2 L'Institut de Rythmologie et Modélisation Cardiaque (LIRYC), Université de Bordeaux, Bordeaux, France.|3 Inserm U1045 CRCTB, Université de Bordeaux, Bordeaux, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Haissaguerre
authors.affiliation: 2 L'Institut de Rythmologie et Modélisation Cardiaque (LIRYC), Université de Bordeaux, Bordeaux, France.|3 Inserm U1045 CRCTB, Université de Bordeaux, Bordeaux, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bernus
authors.affiliation: 1 Department of Paediatric and Adult Congenital Heart defects, University Hospital of Bordeaux, Bordeaux, France.|2 L'Institut de Rythmologie et Modélisation Cardiaque (LIRYC), Université de Bordeaux, Bordeaux, France.|3 Inserm U1045 CRCTB, Université de Bordeaux, Bordeaux, France.
authors.forename: Jean-Benoit
authors.initials: JB
authors.lastname: Thambo
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D004195:Disease Models, Animal; D004452:Echocardiography; D004868:Equipment Failure; D008026:Ligation / Q000009:adverse effects / Q000295:instrumentation; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D011651:Pulmonary Artery / Q000601:surgery*; D013537:Sutures / Q000009:adverse effects*; D013552:Swine; D013771:Tetralogy of Fallot / Q000503:physiopathology / Q000601:surgery*; D016278:Ventricular Function, Right / Q000502:physiology*
keywords: animal model; banding; erosion; tetralogy of Fallot