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Utility of late pulmonary artery banding in single-ventricle physiology: A mid-term follow-up
BACKGROUND: The standard first stage palliation for univentricular heart with unrestricted pulmonary blood flow (PBF) is surgical pulmonary artery (PA) banding for which the ideal age is within the first 8 weeks of life. This study aimed to look for the utility of PA band done beyond 3 months of age...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918013/ https://www.ncbi.nlm.nih.gov/pubmed/33679058 http://dx.doi.org/10.4103/apc.APC_128_20 |
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author | Mukherji, Aritra Ghosh, Sanjiban Pathak, Nihar Das, Jayita Nandi Dutta, Nilanjan Das, Debasis Chattopadhyay, Amitabha |
author_facet | Mukherji, Aritra Ghosh, Sanjiban Pathak, Nihar Das, Jayita Nandi Dutta, Nilanjan Das, Debasis Chattopadhyay, Amitabha |
author_sort | Mukherji, Aritra |
collection | PubMed |
description | BACKGROUND: The standard first stage palliation for univentricular heart with unrestricted pulmonary blood flow (PBF) is surgical pulmonary artery (PA) banding for which the ideal age is within the first 8 weeks of life. This study aimed to look for the utility of PA band done beyond 3 months of age for patients presenting beyond the stipulated period. MATERIALS AND METHODS: This is a retrospective analysis of the outcome of twenty patients with single ventricle (SV) physiology with unrestricted PBF who presented late and were selected on the basis of clinical, radiological, and echocardiographic parameters for PA banding. RESULTS: The median age of the patients was 5.5 months (3.5–96 months), and the median body weight was 4.7 kg (3.2–22.0 kg). The patients were divided into three groups as follows: ten patients between 3 and 6 months of age (Group A), seven patients between 6 months to 1 year of age (Group B), and three patients > 1 year of age with additional features of pulmonary venous hypertension (Group C). The mean reduction of PA pressures following PA band was 60.9%, 48.8%, and 58.3% and the mean fall in oxygen saturation was 10.4%, 8.0%, and 6.6% in the three groups, respectively. The postoperative mortality rate was 10%. The mean follow up duration was 13.5 months (7–23 months). There was a statistically significant improvement in weight for age Z scores following PA band (P = 0.0001). On follow up cardiac catheterization, the mean PA pressures were 16.6 (±3.6), 22.7 (±5.7), and 33.3 (±12.4) mmHg, respectively, in the three groups, and the mean pulmonary vascular resistance index was 1.86 (±0.5), 2.45 (±0.7), and 3.5 (±1.6) WU.m2, respectively. Subsequently, seven patients in Group A, three patients in Group B, and one patient from Group C underwent successful bidirectional Glenn (BDG) surgery. CONCLUSIONS: Late PA band in selected patients with SV physiology can have definite benefit in terms of correction of heart failure symptoms and subsequent conversion to BDG and can potentially change the natural history of disease both in terms of survival and quality of life. |
format | Online Article Text |
id | pubmed-7918013 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-79180132021-03-05 Utility of late pulmonary artery banding in single-ventricle physiology: A mid-term follow-up Mukherji, Aritra Ghosh, Sanjiban Pathak, Nihar Das, Jayita Nandi Dutta, Nilanjan Das, Debasis Chattopadhyay, Amitabha Ann Pediatr Cardiol Original Article BACKGROUND: The standard first stage palliation for univentricular heart with unrestricted pulmonary blood flow (PBF) is surgical pulmonary artery (PA) banding for which the ideal age is within the first 8 weeks of life. This study aimed to look for the utility of PA band done beyond 3 months of age for patients presenting beyond the stipulated period. MATERIALS AND METHODS: This is a retrospective analysis of the outcome of twenty patients with single ventricle (SV) physiology with unrestricted PBF who presented late and were selected on the basis of clinical, radiological, and echocardiographic parameters for PA banding. RESULTS: The median age of the patients was 5.5 months (3.5–96 months), and the median body weight was 4.7 kg (3.2–22.0 kg). The patients were divided into three groups as follows: ten patients between 3 and 6 months of age (Group A), seven patients between 6 months to 1 year of age (Group B), and three patients > 1 year of age with additional features of pulmonary venous hypertension (Group C). The mean reduction of PA pressures following PA band was 60.9%, 48.8%, and 58.3% and the mean fall in oxygen saturation was 10.4%, 8.0%, and 6.6% in the three groups, respectively. The postoperative mortality rate was 10%. The mean follow up duration was 13.5 months (7–23 months). There was a statistically significant improvement in weight for age Z scores following PA band (P = 0.0001). On follow up cardiac catheterization, the mean PA pressures were 16.6 (±3.6), 22.7 (±5.7), and 33.3 (±12.4) mmHg, respectively, in the three groups, and the mean pulmonary vascular resistance index was 1.86 (±0.5), 2.45 (±0.7), and 3.5 (±1.6) WU.m2, respectively. Subsequently, seven patients in Group A, three patients in Group B, and one patient from Group C underwent successful bidirectional Glenn (BDG) surgery. CONCLUSIONS: Late PA band in selected patients with SV physiology can have definite benefit in terms of correction of heart failure symptoms and subsequent conversion to BDG and can potentially change the natural history of disease both in terms of survival and quality of life. Wolters Kluwer - Medknow 2021 2020-09-17 /pmc/articles/PMC7918013/ /pubmed/33679058 http://dx.doi.org/10.4103/apc.APC_128_20 Text en Copyright: © 2020 Annals of Pediatric Cardiology http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Mukherji, Aritra Ghosh, Sanjiban Pathak, Nihar Das, Jayita Nandi Dutta, Nilanjan Das, Debasis Chattopadhyay, Amitabha Utility of late pulmonary artery banding in single-ventricle physiology: A mid-term follow-up |
title | Utility of late pulmonary artery banding in single-ventricle physiology: A mid-term follow-up |
title_full | Utility of late pulmonary artery banding in single-ventricle physiology: A mid-term follow-up |
title_fullStr | Utility of late pulmonary artery banding in single-ventricle physiology: A mid-term follow-up |
title_full_unstemmed | Utility of late pulmonary artery banding in single-ventricle physiology: A mid-term follow-up |
title_short | Utility of late pulmonary artery banding in single-ventricle physiology: A mid-term follow-up |
title_sort | utility of late pulmonary artery banding in single-ventricle physiology: a mid-term follow-up |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918013/ https://www.ncbi.nlm.nih.gov/pubmed/33679058 http://dx.doi.org/10.4103/apc.APC_128_20 |
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