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Ann Thorac Surg 2002;74:1219-1224
© 2002 The Society of Thoracic Surgeons

Original article: cardiovascular

Mortality of pulmonary artery banding in the current era: recent mortality of PA banding

Hiroo Takayama, MDa*, Akihiko Sekiguchi, MD, PhDb, Masahide Chikada, MD, PhDb, Mio Noma, MD, PhDb, Akira Ishizawa, MD, PhDb, Shinichi Takamoto, MD, PhDa

a Cardiothoracic Surgery, Tokyo University Hospital, Tokyo, Japan
b Division of Cardiovascular Surgery and Pediatric Cardiology, National Children’s Hospital, Tokyo, Japan

* Address reprint requests to Dr Takayama, Department of Cardiothoracic Surgery, Tokyo University Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
e-mail: hirofu2{at}hotmail.com

Presented at the Thirty-eighth Annual Meeting of The Society of Thoracic Surgeons, Fort Lauderdale, FL, Jan 28–30, 2002.

BACKGROUND: The mortality of pulmonary artery banding improved significantly in the 1980s. However, we lack information on this procedure in the current era.

METHODS: The results of pulmonary artery banding in 365 patients who had operations between 1966 and 2001 were reviewed. The patients were divided into three groups: (1) group 1 patients who had operations between 1966 and 1979, (2) group 2 patients who had operations between 1980 and 1989, and (3) group 3 patients who had operations between 1990 and 2001.

RESULTS: Significantly younger and smaller patients have been operated on recently (mean age: group 1, 169.0 ± 40 days; group 2, 101.8 ± 11 days; and group 3, 69.7 ± 8.9 days; and mean weight: 4.6 ± 0.1, 4.1 ± 0.1, and 3.2 ± 0.1 kg, respectively). A decrease was found in the number of simple cardiac anomalies, such as isolated ventricular septal defects. The early mortality in the three groups was 38.3% for group 1 (65 of 187), 13.5% for group 2 (15 of 111), and 13.8% for group 3 (12 of 87). Although the mortality did not vary significantly between groups 2 and 3, it improved over time in patients weighing less than 3 kg. Multivariate analysis of group 3 demonstrated that no isolated variable, including sex, weight, and diagnosis was a significant risk factor.

CONCLUSIONS: Despite the advances in perioperative management, we found no improvement in the early mortality of pulmonary artery banding during the last decade. These results will support the preference for primary repair of intracardiac anomalies in small infants. However, this operation can now be performed with the same risk even in smaller patients. We believe that pulmonary artery banding has a role in the treatment of congenital cardiac anomalies.




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