Pulmonary Artery Banding in the Current Era: Is It Safe and Useful Yet?

Background: The main goal of this study was to assess the results of the pulmonary Artery (PA) banding in patients with congenital heart defects (CHD) and pulmonary Hypertension (PH). Methods: We analyzed data from 305 patients who had operation between April 2005 and April 2010 in Rajaee Heart Center, Tehran, Iran. All patients were approached through a Left thoracotomy and 20% of patients underwent PA banding based on Tru- sler s rule (Group1), 55% of them underwent PA banding based on PA pressure mea- surement (Group 2), and the rest of them (25%) based on surgeon experience (group 3). The follow-up period was 39±20 month and 75 % of patients (230 cases) had definitive repair of mean interval 23±10 month. Results: The rate of anatomically and functionally effectiveness of PA banding in all groups were high (97% and 92% respectively).There were no significant differences in anatomically and functionally efficacy rate between all groups (p= 0.77, p=0.728 respectively). There was PA bifurcation stenosis in 6 cases (2%), and pulmonary valve injury in 1 case ( 0.3%). There were 11 patients (3.6%) intubated two days or more in intensive care unit (ICU). The mortality rate in PA banding was 2% and in definitive repair was 3%. Conclusion: With low mortality (2%) and morbidity and high efficacy rate of PA banding in our series, we believe that PA banding still plays a role in management of patients with CHD, particularly for infants with medical problems such as sepsis, low body weight, intracranial hemorrhage and associated non cardiac anomalies. We be- lieve that PA banding can be done safely with low morbidity and mortality.