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The Annals of Thoracic Surgery, Vol 44, 628-632, Copyright © 1987 by The Society of Thoracic Surgeons

ARTICLES

Pulmonary artery banding: results and current indications in pediatric cardiac surgery

JG LeBlanc, PG Ashmore, E Pineda, GG Sandor, MW Patterson and M Tipple
Department of Cardiovascular and Thoracic Surgery, Children's Hospital, Vancouver, BC, Canada.

The results of pulmonary artery banding in 144 patients seen from 1971 to 1984 were reviewed. Age ranged from 1 week to 4 years (median, 8 weeks) and weight, from 1.1 to 16 kg (median, 4 kg). The patients were divided into three major groups: Group 1, defects without mixing disorders (ventricular septal defect, double-outlet right ventricle [DORV], atrioventricular septal defect); Group 2, defects with mixing disorders (transposition of the great arteries, DORV, single ventricle, tricuspid atresia); and Group 3, miscellaneous (mitral atresia, left ventricular hypoplasia, truncus complex). The diagnostic group influenced survival (p = 0.0035). In Group 1, 88.8% survived, but only 64.9% survived in Groups 2 and 3 combined. The presence of patent ductus arteriosus or coarctation of the aorta had no effect on survival (p = 0.61 and p = 0.7, respectively). The clinical condition at thirty days after pulmonary artery banding was good in 35.1% and fair in 46.9% of the patients. When the data were divided into the three periods 1971 through 1974, 1975 through 1979, and 1980 through 1984, which included 28, 49, and 67 patients, respectively, a significant improvement in survival was observed from the early (64.3%) to the late period (92.5%) (p = 0.0009). Patients weighing less than 4 kg had a significantly lower survival in the period 1971 through 1974 (37.5% versus 91.67%). No significant difference in survival was detected in the late period, 1980 to 1984 (90% versus 94.6%), between patients weighing less than and those weighing more than 4 kg. Pulmonary artery banding is clinically satisfactory in small infants and children with complex anomalies.

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