Pulmonary Artery Banding in Infants with Cardiac Anomalies Other Than Ventricular Septal Defects: Including an Evaluation of a New Technic for Determining a Critical Degree of Banding

¹ Sutter Community Hospitals, Sacramento, California
² Departments of Pediatrics and Surgery, The University of Oklahoma (Oklahoma City, Oklahoma); The Sutter Community Hospitals (Sacramento, California)

1. Experience with pulmonary artery banding in 14 very ill infants with cyanotic and acyanotic congenital heart disease other than ventricular septal defect, reveals that this procedure resulted in effective palliation in 78 per cent (seven of nine) patients in whom satisfactory banding was achieved.

2. Evaluation of change in pulmonary arterial and systemic arterial oxygen saturation before and after banding proved to be a safe, simple and rapid adjunct for determining critical banding and correlated well with the postoperative evaluation of the adequacy of banding in eight of ten patients.

3. Our findings suggest that survival rate and effective banding are probably associated more with surgical experience than with patient selection or the type congenital heart lesion, since our first three attempts at banding were unsuccessful and two of the other three deaths occurred in patients in whom surgical complications occurred.

4. Our experience indicates that it is quite important that preoperative laboratory evaluation include a careful assessment of great vessel anatomy in order to be as certain as possible concerning the exact position of the great vessels and the presence or absence of a significant size ductus arteriosus.