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Efficacy and safety of percutaneous transluminal balloon dilation to prevent progression of banding site stenosis after bilateral pulmonary artery banding
Author(s) -
Hoshino Shinsuke,
Kitano Masataka,
Abe Tadaaki,
Yazaki Satoshi,
Kagisaki Koji
Publication year - 2015
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.25868
Subject(s) - medicine , stenosis , balloon dilation , percutaneous , hypoplastic left heart syndrome , balloon , surgery , pulmonary artery banding , lumen (anatomy) , pulmonary artery , cardiology , heart disease
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. © 2015 Wiley Periodicals, Inc.