PULMONARY-ARTERY BANDING WITH A NOVEL PERCUTANEOUSLY, BIDIRECTIONALLYADJUSTABLE DEVICE

Pulmonary artery banding is commonly performed as a palliative procedu re in complex congenital heart disease; when pulmonary blood flow is i ncreased. However, the hemodynamics may change postoperatively requiri ng readjustment of the band, which may necessitate a second operation. We report a new system for pulmonary artery banding which allows prec ise placement of the band intraoperatively, as well as bidirectional p ercutaneous adjustment of the band postoperatively. Via left lateral t horacothomy the new device was implanted without complications into a neonate with congestive heart failure due to tricuspid atresia (IIc) a nd coarctation of the aorta. Although optimal placement of the band ha d been achieved intraoperatively the band had to be tightened 25 h aft er the operation and released 85 h after the operation in order to opt imize hemodynamics. The bidirectionally adjustable device for banding of the pulmonary artery is superior to previously used devices with ei ther no or unidirectional adjustability of the band because it is safe and easy to implant and has the potential to reduce the number of reo perations associated with this type of procedure. (C) 1997 Elsevier Sc ience B.V.