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Original Articles: Cardiovascular

Changing Outcomes of Pulmonary Artery Banding With the Percutaneously Adjustable Pulmonary Artery Band

^a Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India
^b Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India

Accepted for publication July 19, 2007.

^_* Address correspondence to Dr Choudhary, Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi 10029, India (Email: shivchoudhary{at}hotmail.com).

Background: Conventional pulmonary artery banding (CPAB) is associated with high morbidity and mortality. We studied the changes in outcome with the use of an adjustable pulmonary artery band (APAB).

Methods: Between June 2001 and June 2006, 147 patients underwent PAB: 91 underwent CPAB and 56 underwent APAB.

Results: The clinical profile of patients was similar in both groups. Inotropic drugs were used in 91 (100%) patients in the CPAB group and in 12 (21%) in the APAB group (p < 0.001). Early band related reoperation was required in 17 patients in the CPAB group compared with 2 patients in the APAB group (p = 0.014). There were 21 (23%) early deaths in CPAB group compared with 1 (1.8%) in the APAB group (p < 0.001). There was no difference in the intensive care unit stay, hospital stay, and final band gradients in the two groups. On a mean follow-up of 22.8 ± 18.6 months (range, 4 to 72 months), there was PA distortion in 6 patients and band-migration in 4 patients in the CPAB group. These were not observed in the APAB group.

Conclusions: Similar band gradients were achieved with the use of conventional or adjustable PAB. However, the use of this simple and inexpensive technique of APAB was associated with a significant reduction in the early band-related deaths, need for early multiple reoperations, and early adverse acute events, thus making it a safer alternative to CPAB, more so in unstable patients.

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Ann. Thorac. Surg. 2008 85: 598. [Extract] [Full Text] [PDF]

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