Impact of Pulmonary Artery Banding in Patients with Congenital Heart Disease and Pulmonary Hypertension

Abstract

Background: To evaluate the effectiveness of the surgical approach in patients with congenital heart disease and pulmonary hypertension (PH). Methods: This was a retrospective clinical review of patients with congenital heart disease and PH who underwent pulmonary artery banding (PAB) at our institution between January 2013 and January 2023. Results: We identified 219 patients (53.4% males) with a median age of 7 (4.0–15.0) months and a median weight of 6.8 (5.2–9.0) kg at the time of PAB. The median hospital stay was 7.0 (5.0–10.0) days. The in-hospital mortality rate was 4.6%. The median follow-up was 33.0 (17.0–61.0) months. Survival rates were 96.9 ± 2.5% at 60 months and 92.1 ± 6.9% at 120 months post-PAB. 43.8% of patients had a de-banding procedure, and 147 (79.0%) patients received a second-stage procedure (34.7% univentricular, 65.3% biventricular). The mortality rate between stages was 4.3%. 21 (9.6%) patients reached a third-stage procedure. The overall mortality rate was 9.1%. Conclusions: PAB is an acceptable strategy for patients with congenital heart disease complicated with PH. The results and outcomes of subsequent univentricular or biventricular procedures are generally good.

Keywords

• congenital heart disease
• pulmonary hypertension
• pulmonary artery banding
• competing risk analysis