CLINICAL AND HEMODYNAMIC EFFECTS OF PULMONARY ARTERY BANDING

Experience with a large number of pulmonary artery banding procedures performed on diverse groups of patients is presented. A high mortality rate has been observed in patients under 3 months of age, in patients with conotruncal anomalies plus ventricular left to right shunt and in patients with complete atrioventricular canal. The operative mortality rate in patients with ventricular septal defect has improved dramatically in the last few years probably as a result of the combination of later timing of banding and concerted efforts to achieve stable anesthesia, minimal surgical trauma and accurate monitoring of pulmonary and systemic arterial pressures during the procedure. Benefits of pulmonary artery banding, such as improved growth rate, freedom from respiratory infections and improvement in chest roentgenograms and hemodynamic findings, bear a fair correlation with the degree of pulmonary artery constriction (by pressure). Finally, the pulmonary vascular resistance progressively declines in some patients following the pulmonary artery banding, although this response cannot be predicted before surgery. Fibrosis around the pulmonary artery and pericardium is a definite disadvantage inherent in the present technic of banding. © 1968.