Bilateral pulmonary artery banding in higher risk neonates with hypoplastic left heart syndrome

Harold M. Burkhart; Yuki Nakamura; Anas Salkini; Randall M. Schwartz; Courtney D. Ranallo; Elizabeth S. Makil; Matthew Campbell; Suanne M. Daves; Emilie D. Henry; Arshid Mir

doi:10.1016/j.xjon.2023.08.005

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Bilateral pulmonary artery banding in higher risk neonates with hypoplastic left heart syndrome

Journal article

Peer reviewed

Bilateral pulmonary artery banding in higher risk neonates with hypoplastic left heart syndrome

Harold M. Burkhart, Yuki Nakamura, Anas Salkini, Randall M. Schwartz, Courtney D. Ranallo, Elizabeth S. Makil, Matthew Campbell, Suanne M. Daves, Emilie D. Henry and Arshid Mir

JTCVS open, Vol.16, pp.689-697

12/01/2023

DOI: 10.1016/j.xjon.2023.08.005

PMID: 38204678

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Abstract

Limited data on performing bilateral pulmonary artery banding (BPAB) before stage 1 Norwood procedure suggest that some patients may benefit through the postponement of the major cardiopulmonary bypass procedure. The objective of this study was to evaluate the effectiveness of BPAB in the surgical management of high-risk patients with hypoplastic left heart syndrome (HLHS). A retrospective review of all high-risk neonates with HLHS who underwent BPAB at our institution was performed. No patients, including those with intact or highly restrictive atrial septum (IAS), were excluded. Between October 2015 and April 2021, 49 neonates with HLHS (including 6 with IAS) underwent BPAB, 40 of whom progressed to the Norwood procedure. Risk factors for not progressing to the Norwood procedure after BPAP include low birth weight (P = .043), the presence of multiple extracardiac anomalies (P = .005), and the presence of genetic disorders (P = .028). Operative mortality was 7.5% (3/40). IAS was associated with operative mortality (P = .022). The strategy of BPAB prestage 1 Norwood procedure was successful in identifying at-risk patients and improving Norwood survival. Although not all patients will need this hybrid approach, a significant number can be expected to benefit from this tactic. These results support the need for a substantial hybrid strategy, in addition to a primary stage 1 Norwood surgical strategy, in the management of HLHS.

bilateral pulmonary artery bands

congenital cardiac surgery

hypoplastic left heart syndrome

Norwood

single-ventricle palliation

Details

Title: Subtitle: Bilateral pulmonary artery banding in higher risk neonates with hypoplastic left heart syndrome
Creators: Harold M. Burkhart - University of Oklahoma Health Sciences Center
Yuki Nakamura - University of Oklahoma Health Sciences Center
Anas Salkini - University of Oklahoma Health Sciences Center
Randall M. Schwartz - University of Oklahoma Health Sciences Center
Courtney D. Ranallo - University of Oklahoma Health Sciences Center
Elizabeth S. Makil - University of Oklahoma Health Sciences Center
Matthew Campbell - University of Oklahoma Health Sciences Center
Suanne M. Daves - University of Oklahoma Health Sciences Center
Emilie D. Henry - University of Oklahoma Health Sciences Center
Arshid Mir - University of Oklahoma Health Sciences Center
Resource Type: Journal article
Publication Details: JTCVS open, Vol.16, pp.689-697
DOI: 10.1016/j.xjon.2023.08.005
PMID: 38204678
ISSN: 2666-2736
eISSN: 2666-2736
Publisher: Elsevier Inc
Language: English
Date published: 12/01/2023
Academic Unit: Cardiothoracic Surgery
Record Identifier: 9985164052302771

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