Pulmonary Artery Banding for Neonates and Early Infants with Low Body Weight

Pulmonary Artery Banding for Neonates and Early Infants with Low Body Weight

MITSUGI NAGASHIMA,¹ TORU OKAMURA,¹ FUMIAKI SHIKATA,¹ TOSHIYUKI CHISAKA,² HIDEMI TAKATA,² MASAAKI OHTA,² EIICHI YAMAMOTO² and TAKASHI HIGAKI²

¹Department of Surgery, Division of Pediatric Cardiovascular Surgery, Ehime University School of Medicine, Ehime, Japan
²Department of Pediatrics, Ehime University School of Medicine, Ehime, Japan

Open heart surgery for infants with low body weight (BW) remains still a challenge. Pulmonary artery banding (PAB) is a useful surgical palliation for small neonates and early infants with excessive pulmonary blood flow who are unable to withstand a heart surgery. This study retrospectively reviewed neonates and infants who underwent PAB to assess the surgical results and the validity of our PAB. We selected 38 acyanotic infants and neonates and divided them into 2 groups: low BW (< 2.5 kg, n = 15, group L) and normal or high BW (≥ 2.5 kg, n = 23, group NH). The average BW at the time of PAB was 2.8 ± 1.1 kg (range, 1.2-5.8 kg), and the average age at the time of PAB was 41.8 ± 44.8 days (range, 2-151 days). Using a 3-mm-wide polyester tape, we tightened the main pulmonary artery to obtain the circumference of (19 mm + 1 mm for each kg of BW). There was no early death but one late death in each group. Postoperative BW continuously increased 1 month after PAB in both groups, although BW was significantly lower in group L than in group NH. Intracardiac repair (ICR) was accomplished in 31 patients (13 in group L and 18 in group NH) at average ages of 1.5 years, while the remaining 5 patients are awaiting ICR. In conclusion, PAB using our formula for the infants even weighing < 2.5 kg has low mortality and is effective as a bridge to ICR.

keywords —— infant; low birth weight; neonate; palliative surgery; pulmonary artery banding

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Tohoku J. Exp. Med., 2011, 225, 255-262

Correspondence: Mitsugi Nagashima, M.D., Department of Surgery, Division of Pediatric Cardiovascular Surgery, Ehime University School of Medicine, Shitsukawa, Toon City, Ehime 791-0295, Japan.

e-mail: mitsugi@aqua.plala.or.jp or mitsugi@m.ehime-u.ac.jp