15 February 2020 by Susan Pumacayo

Pulmonary banding, solution or problem in a third level hospital, Peru

Background: In our country, there are no studies on the evaluation of pulmonary artery banding (BAP) in children with congenital heart disease and pulmonary hyperflow.

Objective: To determine BAP results in patients with congenital heart disease and pulmonary hyperflow in a third level hospital, Lima, Perú.

Methods: Review of clinical records of patients operated on BAP, who met the selection criteria. Descriptive statistics were used.

Results: There were 38 pulmonary banding procedures. The most frequent female sex (63%), from Lima (84%), 94% were RNAT and PAEG, 47% had Down syndrome and 71% had some genetic syndrome. The most frequent heart disease was CIV plus PCA (52.6%). The most frequent age was 1 month to 6 months (52.6%). The most frequent weight was 3500gr. The most frequent preoperative comorbidity was sepsis (26%). The most frequent surgical technique was the usual> 90% of the cases and in 21% surgical closure of PCA was also performed. The most frequent O2 saturation was 83-96% and the average transbanding gradient was 56 mmHg. The most frequent postoperative clinical features were: inadequate nutritional recovery 21.1%, persistent ICC (first 6 months) 44.7% and functional class improvement in 36.8%. The most frequent intraoperative complication was hypotension plus severe bradycardia. The most frequent early postoperative complication was CHF 50%. The most frequent late complication was pulmonary trunk dilatation 47.4%. The postoperative stay in ICU was 24 days, average. Mortality was 36.84%. The mean waiting time for the BAP was 3.9 months. The reference waiting time for corrective surgery was 18.8 months. The average waiting time for corrective surgery was 6 months.

Conclusion: BAP is a procedure prior to corrective surgery that requires an adequate selection of patients, our study has shown improvement of the patients in the postoperative period, however, it is necessary to decrease the high risk of mortality and shorten the reference for corrective surgery.

About the author

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Susan Pumacayo

Cardiólogo Pediatra

Hospital Nacional Edgardo Rebagliatti Martins


Key Contributors

Susan Pumacayo-Cárdenas, Edgar Quea-Pinto Department of Specialized Pediatrics. Edgardo Rebagliati Martins National Hospital, Lima, Perú.

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