EFFICACY OF PULMONARY-ARTERY BANDING IN THE PREVENTION OF PULMONARY VASCULAR OBSTRUCTIVE DISEASE

In 57 nonconsecutive pediatric patients (mean age: 2.6 months) with sh unt-related pulmonary hypertension, the efficacy of pulmonary artery b anding (PAB) was analysed retrospectively with special reference to th e development of pulmonary vascular obstructive disease (PVOD). The pa tients were grouped in accordance to morphology, hemodynamics and inci dence of PVOD. Efficacy of PAB was assessed by pulmonary to systemic p ressure, flow and resistance ratios obtained by heart catheterization performed pre- and postoperatively. PAB was very effective in 49 out o f 57 patients (= 85.9%), in 8 cases a progression or possible progress ion of PVOD must be suggested. Only Down syndrome can be considered as a predisposing factor for the development of PVOD. Based on our resul ts we conclude that PAB is a high effective procedure in the preventio n of PVOD; however, despite the surgical effectiveness of PAB, PVOD ca n occur. Strict post-PAB examination of pulmonary flow and resistance parameters is recommended and the definite surgical repair should be p erformed as early as possible.