Efficacy and safety of percutaneous transluminal balloon dilation to prevent progression of banding site stenosis after bilateral pulmonary artery banding.

Abstract

OBJECTIVES:

To investigate the efficacy and safety of percutaneous transluminal balloon dilation (PTBD) for the treatment of bilateral pulmonary artery banding (bil-PAB) site stenosis.

BACKGROUND:

Although bil-PAB is an alternative initial treatment for high-risk neonates with hypoplastic left heart syndrome (HLHS) or critical aortic stenosis (cAS), those patients often suffer from desaturation because of progressive stenosis of the bil-PAB sites during the interstage period.

METHODS:

We retrospectively evaluated the efficacy and safety of 11 consecutive PTBD procedures performed between 2006 and 2012 to treat bil-PAB site stenosis in four high-risk infants (three females) with HLHS or cAS.

RESULTS:

PTBD was repeated twice in two patients and three times in one patient over intervals. The mean balloon diameter (BD) and BD-to-band circumference (BC) ratio were 3.1 ± 0.5 mm and 0.31 ± 0.06, respectively. After the procedures, the mean minimum lumen diameter was dilated significantly from 1.1 ± 0.1 mm to 1.7 ± 0.3 mm (P < 0.01), and the mean peripheral oxygen saturation increased significantly from 75 ± 8% to 85 ± 4% (P < 0.01). All patients reached the next stage operation involving the Norwood & bidirectional Glenn or Ross procedure, after growth. No complications such as band rupture occurred.

CONCLUSIONS:

For progressive stenosis of bil-PAB sites, PTBD using a balloon size that did not exceed the BC (BD around 30% of the BC) was an effective and safe procedure.

• Authors: Shinsuke Hoshino, Masataka Kitano, Tadaaki Abe, Satoshi Yazaki, Koji Kagisaki
• Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (Catheter Cardiovasc Interv) Vol. 85 Issue 7 Pg. E197-202 (Jun 2015) ISSN: 1522-726X [Electronic] United States
• PMID: 25639268 (Publication Type: Journal Article)
• Copyright: © 2015 Wiley Periodicals, Inc.

Topics

• Angioplasty, Balloon (adverse effects, instrumentation)
• Aortic Valve Stenosis (diagnosis, physiopathology, surgery)
• Arterial Occlusive Diseases (diagnosis, etiology, physiopathology, therapy)
• Constriction, Pathologic
• Disease Progression
• Equipment Design
• Female
• Humans
• Hypoplastic Left Heart Syndrome (diagnosis, physiopathology, surgery)
• Infant, Newborn
• Male
• Norwood Procedures (adverse effects)
• Pulmonary Artery (diagnostic imaging, physiopathology, surgery)
• Radiography
• Retrospective Studies
• Risk Factors
• Time Factors
• Treatment Outcome
• Vascular Access Devices