Feasibility and related outcome of XXXX banding.

@entity1 @entity8521 @entity301 @entity1757 @entity120 @entity474 @entity358 @entity4263
OBJECTIVES: This retrospective study evaluated the feasibility and related outcome of @entity358 banding (I-PAB). METHODS: Thirty-two @entity1 underwent I-PAB between July 2006 and April 2014. The median age and weight were 60 days (range: 5 days to 4.2 years) and 3.7 kg (range: 2.6-13.0 kg), respectively. Cardiac diagnoses included single ventricle morphology (n = 11), complex @entity1757 (n = 11), balanced @entity474 (n = 3), @entity4263 (n = 2) and @entity8521 with @entity1757 (n = 5). On cardiopulmonary bypass (CPB), 2 I-PAB modifications with either 1 (n = 24) or 2 ('hour-glass-technique', n = 8) fenestrated pericardial patches were performed. RESULTS: The median fenestration size was 5 mm (range: 4-6.5 mm). In 18 @entity1 I-PAB was a solitary procedure; in 3 of them the decision was made intraoperatively. There was no hospital mortality. The median interval to debanding was 189 days (range: 112 days to 2.6 years). During this period, we observed a significant increase in the pressure gradient over I-PAB (P < 0.01), whereas arterial saturations remained stable. Four @entity1 received balloon dilatation of I-PAB to prolong the palliation period. No @entity1 experienced band occlusion, @entity120 related to I-PAB, @entity301 . Debanding was performed in 27 @entity1 and one of them required pulmonary patch arterioplasty due to I-PAB-associated @entity358 . Three @entity1 are still awaiting further surgery. There were 2 late deaths prior to, and 3 after debanding, all not related to I-PAB. CONCLUSIONS: I-PAB with an exactly defined internal orifice is feasible and effective. Although arterial saturations seem to remain stable, balloon dilatation of I-PAB can be performed safely and efficiently in order to prolong the palliation period. The rate of I-PAB-related complications is low, which might improve the long-term @entity1 outcome. Therefore, despite requiring CPB, I-PAB is our institutional preference for @entity1 who require pulmonary artery banding.
