Abstract
Development of a reliable reversible pulmonary artery band (PAB) might obviate the need for a second cardiac surgical procedure in children with some forms of congenital heart disease. We evaluated dissolvable polydioxanone (PDS) mesh and 4 mm wide segmented silastic bands (SSB) sewn together with 7-0 PDS suture for use as a reversible PAB. Seven mongrel puppies (P), average wt=7.7 kg, were divided into 2 groups (Grp): Grp I (4 P) received SSB, Grp II (3 P) received PDS mesh. No immediate pressure gradient resulted from PAB placement. All P underwent cardiac catheterization monthly. Three months after PAB placement Grp I right ventricular (RV) systolic pressure varied between 30 and 60 mmHg with systolic pressure gradient between 13 and 27 mmHg (mean=19.3); in Grp II, none developed gradients over 10 mmHg. Grp I P underwent balloon angioplasty (BA) with decrease in average gradient from 21.3 to 7.3 mmHg and average RV systolic pressure from 46.7 to 27 mmHg. All P were sacrificed and the PAB site examined grossly and microscopically. No evidence of PDS mesh or fibrous scarring was found in Grp II P. In Grp I P a fibrous capsule enveloped the SSB with no evidence of remaining PDS suture. P undergoing BA had fracture of the capsule without evidence of injury to the pulmonary artery.
Our data demonstrates that a reversible PAB is feasible and that SSB is superior to PDS mesh.
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Duncan, D., Harris, P., O'Brien, D. et al. REVERSIBLE PULMONARY ARTERY BANDING: DISSOLVABLE POLYDIOXANONE MESH VS SEGMENTED SILASTIC BANDS. Pediatr Res 21 (Suppl 4), 189 (1987). https://doi.org/10.1203/00006450-198704010-00140
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DOI: https://doi.org/10.1203/00006450-198704010-00140