Outcome of Pulmonary Artery Banding without Cardiopulmonary Bypass in Infants Weighing Less than 2.5 kg

Abstract

Background: Congenital heart defects have been an important cause for death among low birth weight (LBW) infants. Corrective surgery is not always a favorable solution for these fragile babies, and surgeons may choose palliative surgery, which is technically demanding. We reviewed our 10 years of experience and the outcome of initial pulmonary artery banding (PAB) without cardiopulmonary bypass (CPB) in LBW infants. Patients and methods: Eleven infants (age, 6～78 days; body weight, 1.1～2.5 kg) underwent initial PAB with- out CPB (9 cases of main PAB and 2 cases of branch PAB). Results: One patient died from a non-cardiac event. Nine patients successfully underwent the second-stage operation, at a mean weight of 4.6 kg, and eight completed the final stage. One patient experienced ventricular volume overload aſter main PAB. The mean Pp/Ps (pulmonary systemic blood pressure ratio) was 0.54 and the circumference of the band for the main PAB was body weight (kg)＋18.2 mm, which was a little tighter than Tru- sler’s rule. The circumference for the branch PAB was body weight (kg)＋8.0 mm. Of the patients who weighed less than 2 kg, all five gained body weight, and four of them successfully reached the final stage. Conclusion: PAB in LBW infants resulted in fair clinical outcomes with acceptable morbidity and mortality. How- ever, there is a need for specific guidance, based on accumulated experience, for the procedure and management