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Univentricular Pulmonary Artery Banding: How Tight is Tight Enough for Successful Progress?
- Source :
- Pediatric Cardiology. 42:840-848
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- We investigated the effects of intraoperative parameters measured during pulmonary artery banding operations and pre-discharge parameters on the completion of Fontan procedures. Fifty consecutive patients with single-ventricle anomalies and unrestricted pulmonary blood flow who underwent a PAB operation in and were discharged from our hospital were retrospectively analyzed. Patients who underwent a Fontan operation, a Glenn shunt operation, or who were eligible for a Fontan procedure were defined as the "successful group." Patients who needed rebanding prior to a bidirectional Glenn shunt, patients who were not eligible for a Glenn shunt, and those underwent a takedown due to high pulmonary arterial pressure after implantation of a Glenn shunt were defined as the "failure-to-progress group." The successful group included 34 (68%) patients and the failure-to-progress group included 16 (32%) patients. The median age was 2 months (IQR 1-4 months). There was a statistically significant difference between the groups in terms of systolic pulmonary arterial pressure, mean pulmonary arterial pressure, and pulmonary arterial pressure/systemic arterial pressure after PAB (P = 0.01, 0.03, and 0.03, respectively). While the median gradient before discharge was 60 mm Hg (IQR 50-70 mm Hg) in the successful group, it was 47.5 mm Hg (IQR 45-63.7 mm Hg) in the failure-to-progress group (P = 0.05). Mortality was observed in one (2.9%) patient in the successful group and five (31.2%) patients in the failure-to-progress group (P = 0.04). Successful pulmonary arterial banding increases long-term survival. Adequate targets should be determined, efforts should be made to achieve these targets, and patients should be followed up closely in terms of rebanding when the targets are not reached.
- Subjects :
- Heart Defects, Congenital
Male
Pulmonary Circulation
medicine.medical_specialty
medicine.medical_treatment
Pulmonary Artery
030204 cardiovascular system & hematology
Fontan Procedure
Pulmonary artery banding
Fontan procedure
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Pulmonary blood flow
Arterial Pressure
Treatment Failure
Retrospective Studies
business.industry
Significant difference
Infant
Vascular surgery
Cardiac surgery
Treatment Outcome
medicine.anatomical_structure
Blood pressure
030228 respiratory system
Child, Preschool
Pediatrics, Perinatology and Child Health
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Artery
Subjects
Details
- ISSN :
- 14321971 and 01720643
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Pediatric Cardiology
- Accession number :
- edsair.doi.dedup.....ce42b6436305f4c6fbde9691bf848dbf