Pulmonary artery banding is a palliative surgical procedure used to decrease excessive pulmonary blood flow. It is usually used for neonates and infants with left-to-right shunts unable to withstand complete surgical correction.
Some indications include:
- single ventricle
- multiple ventricular septal defects
- atrioventricular septal defects
- double outlet right ventricle
- double outlet left ventricle
- unrepaired transposition of the great arteries in neonates to prepare the left ventricle to receive a higher systemic pressure load prior to arterial switch procedure
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Procedure
The current technique of pulmonary artery banding usually involves encircling the main pulmonary artery with a ring of prosthetic material, which restricts pulmonary blood flow, increases systemic perfusion and protects the pulmonary vasculature from changes of pulmonary hypertension.
Complications
Complications of pulmonary artery banding include:
- dilatation of the proximal pulmonary artery
- pulmonary valve insufficiency
- pulmonary valve injury
- band migration which may compromise blood flow
History and etymology
The procedure was introduced by William H Muller, Jr and J Francis Dammann, Jr in 1951 and was initially used in an infant with a ventricular septal defect.