Banding of the Pulmonary Artery for Transposition of the Great Arteries and Ventricular Septal Defect
The palliative procedures for TGA with VSD and pulmonary hypertension include pulmonary artery banding, atrial septostomy, and, when necessary, ligation of a patent ductus arteriosus. This paper presents the surgical results and physiological consequences of the palliative approach. The overall mortality was 12% (4 of 33 patients).
It was possible to lower the Pp to below 45 mm Hg in all 15 infants with pulmonary artery banding. Ten infants recatheterized after the operation had no evidence of progressive pulmonary vascular disease. In 6 of 18 children older than one year, the Pp remained higher than 45 mm Hg distal to the band. In six children recatheterized, the pulmonary flow had decreased from preoperative levels, and the calculated Rp/Rs ratio had not changed significantly. The arterial oxygen saturation was decreased after banding of the pulmonary artery in 16 of 20 patients in whom it was measured.
These data suggest that pulmonary artery banding can prevent the development of pulmonary vascular disease in infants. In children older than one year, pulmonary vascular disease can be arrested at the stage that it had reached at the time of banding the pulmonary artery.
- © 1970 American Heart Association, Inc.