Skip to main content
Erschienen in: Pediatric Cardiology 3/2016

22.12.2015 | Original Article

Optimal Timing of Pulmonary Banding for Newborns with Single Ventricle Physiology and Unrestricted Pulmonary Blood Flow

verfasst von: K. Ramakrishnan, F. A. Alfares, K. Hammond-Jack, K. Endicott, M. Nettleton, D. Zurakowski, R. A. Jonas, D. S. Nath

Erschienen in: Pediatric Cardiology | Ausgabe 3/2016

Einloggen, um Zugang zu erhalten

Abstract

The aim of this study was to determine the optimal timing of pulmonary artery band (PAB) placement in neonates with single ventricle physiology, unrestricted pulmonary blood flow, and no systemic outflow tract obstruction. Retrospective chart review of all patients who underwent isolated PAB for single ventricle physiology between January 2005 and December 2014 was carried out. The influence of age at the time of PAB on operative mortality, the need for reoperation to adjust the PAB, the preparedness of the pulmonary vascular bed prior to the second-stage bidirectional cavopulmonary shunt (BCPS), and the outcomes following BCPS were studied. The study cohort included 54 subjects (34 males). The median age at the time of PAB was 18 days. The overall mortality following PAB was 4 % (2/54). Reoperation for PAB adjustment was 7 % (4/54). Younger age at the time of PAB was not associated with mortality or increased risk of reoperation. There was a mild positive correlation between the age at PAB and the mean pulmonary artery pressure prior to BCPS. There was also a weak positive correlation between the age at PAB and the duration of ventilation following BCPS. Age at the time of PAB did not influence pulmonary vascular resistance (PVR) prior to BCPS or the mortality and hospital stay following BCPS. PAB can be done safely and effectively soon after birth in neonates with single ventricle physiology, increased pulmonary blood flow, and no potential or actual systemic outflow tract obstruction. It may not be necessary to wait for a few weeks after birth for the neonatal PVR to fall before placing a PAB.
Literatur
1.
Zurück zum Zitat Alsoufi B, Schlosser B, Mori M, McCracken C, Slesnick T, Kogon B, Petit C, Sachdeva R, Kanter K (2015) Influence of morphology and initial surgical strategy on survival of infants with tricuspid atresia. Ann Thorac Surg. doi:10.1016/j.athoracsur.2015.05.037 Alsoufi B, Schlosser B, Mori M, McCracken C, Slesnick T, Kogon B, Petit C, Sachdeva R, Kanter K (2015) Influence of morphology and initial surgical strategy on survival of infants with tricuspid atresia. Ann Thorac Surg. doi:10.​1016/​j.​athoracsur.​2015.​05.​037
2.
Zurück zum Zitat Dehaki MG, Tabaee AS, Ahmadabadi CA, Ghavidel AA, Omra G (2012) Pulmonary artery banding in the current era: is it still useful? Ann Pediatr Cardiol 5(1):36–39CrossRefPubMedPubMedCentral Dehaki MG, Tabaee AS, Ahmadabadi CA, Ghavidel AA, Omra G (2012) Pulmonary artery banding in the current era: is it still useful? Ann Pediatr Cardiol 5(1):36–39CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Horowitz MD, Culpepper WS 3rd, Williams LC 3rd, Sundgaard-Riise K, Ochsner JL (1989) Pulmonary artery banding: analysis of a 25-year experience. Ann Thorac Surg 48(3):444–450CrossRefPubMed Horowitz MD, Culpepper WS 3rd, Williams LC 3rd, Sundgaard-Riise K, Ochsner JL (1989) Pulmonary artery banding: analysis of a 25-year experience. Ann Thorac Surg 48(3):444–450CrossRefPubMed
4.
Zurück zum Zitat Jone PN, Schowengerdt KO Jr (2009) Prenatal diagnosis of congenital heart disease. Pediatr Clin N Am 56(3):709–715CrossRef Jone PN, Schowengerdt KO Jr (2009) Prenatal diagnosis of congenital heart disease. Pediatr Clin N Am 56(3):709–715CrossRef
5.
Zurück zum Zitat Kouchoukos NT, Blackstone EH, Hanley FL, Kirklin JK (2013) Tricuspid atresia and single-ventricle physiology. In: Kirklin JK, Barratt-Boyes BG (eds) Cardiac surgery: morphology, diagnostic criteria, natural history, techniques, results, and indications. Saunders, Philadelphia, PA, p 1525 Kouchoukos NT, Blackstone EH, Hanley FL, Kirklin JK (2013) Tricuspid atresia and single-ventricle physiology. In: Kirklin JK, Barratt-Boyes BG (eds) Cardiac surgery: morphology, diagnostic criteria, natural history, techniques, results, and indications. Saunders, Philadelphia, PA, p 1525
6.
Zurück zum Zitat LeBlanc JG, Ashmore PG, Pineda E, Sandor GG, Patterson MW, Tipple M (1987) Pulmonary artery banding: results and current indications in pediatric cardiac surgery. Ann Thorac Surg 44(6):628–632CrossRefPubMed LeBlanc JG, Ashmore PG, Pineda E, Sandor GG, Patterson MW, Tipple M (1987) Pulmonary artery banding: results and current indications in pediatric cardiac surgery. Ann Thorac Surg 44(6):628–632CrossRefPubMed
7.
Zurück zum Zitat Mahle WT, Newburger JW, Matherne GP, Smith FC, Hoke TR, Koppel R, Gidding SS, Beekman RH 3rd, Grosse SD (2009) American Heart Association Congenital Heart Defects Committee of the Council on Cardiovascular Disease in the Young, Council on Cardiovascular Nursing, and Interdisciplinary Council on Quality of Care and Outcomes Research; American Academy of Pediatrics Section on Cardiology and Cardiac Surgery, and Committee on Fetus and Newborn. Role of pulse oximetry in examining newborns for congenital heart disease: a scientific statement from the American Heart Association and American Academy of Pediatrics. Circulation 120(5):447–458CrossRefPubMed Mahle WT, Newburger JW, Matherne GP, Smith FC, Hoke TR, Koppel R, Gidding SS, Beekman RH 3rd, Grosse SD (2009) American Heart Association Congenital Heart Defects Committee of the Council on Cardiovascular Disease in the Young, Council on Cardiovascular Nursing, and Interdisciplinary Council on Quality of Care and Outcomes Research; American Academy of Pediatrics Section on Cardiology and Cardiac Surgery, and Committee on Fetus and Newborn. Role of pulse oximetry in examining newborns for congenital heart disease: a scientific statement from the American Heart Association and American Academy of Pediatrics. Circulation 120(5):447–458CrossRefPubMed
8.
Zurück zum Zitat Sasikumar N, Ramanan S, Rema KM, Subramanyan R, Kumar RS, Cherian KM (2013) Pulmonary artery banding for univentricular heart beyond the neonatal period. Asian Cardiovasc Thorac Ann 22(6):660–666CrossRefPubMed Sasikumar N, Ramanan S, Rema KM, Subramanyan R, Kumar RS, Cherian KM (2013) Pulmonary artery banding for univentricular heart beyond the neonatal period. Asian Cardiovasc Thorac Ann 22(6):660–666CrossRefPubMed
Metadaten
Titel
Optimal Timing of Pulmonary Banding for Newborns with Single Ventricle Physiology and Unrestricted Pulmonary Blood Flow
verfasst von
K. Ramakrishnan
F. A. Alfares
K. Hammond-Jack
K. Endicott
M. Nettleton
D. Zurakowski
R. A. Jonas
D. S. Nath
Publikationsdatum
22.12.2015
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 3/2016
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-015-1321-3

Weitere Artikel der Ausgabe 3/2016

Pediatric Cardiology 3/2016 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.