Pulmonary artery banding as a choice in surgical treatment of the congenital heart diseases

Abstract

Background: Pulmonary artery banding (PAB) is a simple surgical technique to reduce pulmonary overcirculation in some congenital heart diseases. Initially, when the use of cardiopulmonary bypass was affected by many deleterious effects, this technique played a fundamental role in the treatment of patients with congenital heart defects and an intracardiac left-to-right shunt. The use of PAB has decreased during the last two decades due to the increasing popularity of early complete intracardiac repair. Conclusions: PAB has been performed in cases other than classic univentricular heart, as palliation in small infants with cardiac defects with a left-to-right shunt and pulmonary overcirculation, thus gaining some time prior to a planned staged repair. Recently, the role of PAB is becoming more important in selected subsets of congenital cardiac defects: L-transposition of the great arteries, D-transposition of the great arteries, hypoplastic left heart syndrome, moderately hypoplastic left ventricle (congenitally corrected transposition of the great arteries). PAB should be applied only when radical correction cannot be performed. Radical surgical correction is the chosen treatment for children with congenital heart diseases complicated by severe pulmonary hypertension.