Featured InnovationPulmonary artery banding in infants and young children with left ventricular dilated cardiomyopathy: A novel therapeutic strategy before heart transplantation
Section snippets
Patients and methods
From April 2006 to December 2012, 56 patients aged younger than 3 years old were referred to our Pediatric Heart Center because of dilative LV heart failure. Of these, 17 received a surgical PAB. In 5 of the 17 patients with LVDCM, a PAB was performed in addition to open heart surgery for repair of a left-sided anomalous pulmonary venous return, large atrial septal defect by fenestrated patch, reimplantation of an anomalous origin of the left coronary artery from the pulmonary artery, and
Results
PAB was successfully performed in all patients. There were no hospital deaths. Most valuable clinical, echocardiographic, MRI and BNP data before and after PAB are presented as single values of each patient and summarized in Table 1 , Table 2 .
After an individualized tightening of the PAB, a systolic RV pressure as a level of 60% to 70% of the systolic arterial blood pressure was achieved in all patients. The pressure gradient across the PAB increased significantly (p > 0.01) from 28 ± 7 mm Hg
Discussion
Common unfavorable outcomes of DCM are death, usually resulting from congestive heart failure or sudden cardiac death, and HTx. Reported freedom from death and HTx are 72% and 69% at 1 year and 63% and 54% at 5 years.1, 12 Survival rates from the time of the DCM diagnosis have been unchanged for several decades.13, 14 Thus, there is a need to pursue additional strategies to avoid or to delay HTx in the pediatric DCM population. We hypothesized that PAB might serve as such a novel therapeutic
Disclosure statement
None of the authors has a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose.
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Late left ventricular myocardial remodeling after pulmonary artery banding for end-stage dilated cardiomyopathy in infants: an imaging study
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