AEPC-YIA session（I-AEPCYIA）

[I-AEPCYIA-06] Transcatheter Balloon Dilation of Pulmonary Artery Band outcomes : A Multi-centre Study

^○Precylia Philo Fernandes ¹, Patrick Noonan ¹, Ryan Abumehdi ^2,3, Oliver Stumper², Ahmed Alfifi², Matthew Jones³, Sok Leng Kang⁴, Ines Hribernik⁵, Jamie Bentham⁵, Najih Muhammad Liaqath Ali⁶, Nicholas Hayes⁶, Abhishek Oswal⁷, Demetris Taliotis⁷ (1.Royal Hospital for Children Glasgow, UK, 2.Birmingham Childrens Hospital, UK, 3.Evelina Childrens Hopsital London, UK, 4.Alder Hey Childrens Hospital Liverpool, UK, 5.Leeds Childrens Hospital, UK, 6.Southampton General Hospital, UK, 7.Bristol Childrens Hospital, UK)

キーワード：PAB, pulmonary artery banding dilatation, pulmonary artery debanding

BACKGROUND AND AIM : Pulmonary Artery banding(PAB) is an operation carried out for congenital heart defects, essentially to control increased pulmonary blood flow. This is performed to protect pulmonary vasculature from long term irreversible changes and damage leading to pulmonary hypertension while awaiting complete repair or also as destination therapy. There are very few studies and case reports in the literature that review the long-term outcomes of the patients who underwent percutaneous de-banding of pulmonary artery bands (bPAB). We aimed to assess the safety and efficacy of balloon dilatation of PAB and review the outcomes. METHOD : Data was collected from seven Cardiothoracic centres within UK according a proposed excel spread sheet after ethical approval. PAB safety was determined from short term outcomes such as immediate post intervention clinical status, length of stay in hospital, survival to discharge, complication rate and long-term outcome included survival at 1 year. Efficacy of the procedure was determined by assessing the Invasive and non-invasive gradient and oxygen saturations pre and post procedure. RESULTS:7 UK wide cardiothoracic centres data from Jan 2010 to Jan 2021 was analysed. A total of 64 patients underwent 65 bPAB procedures. Median age was 15months and median weight was 9.4kg at intervention. M:F ratio was 1.2:1 Average post operative length of stay was 1-2 days and follow up median duration was 3yrs. There was statistically significant reduction in median invasive gradient from 53mmHg to 24mmHg (p value of <0.001) and median transthoracic echo gradient from 74mmHg to 45mmHg (p value of <0.001) post intervention. Major post operative complications included 1 hemopericardium and 1 death. Mortality was associated with patient who underwent concomitant VSD closure. Overall major complication rate of 3.1% and minor complication was 4.6% . CONCLUSIONS : bPAB appears to be effective to achieve desired loosening of the band. There is low intraoperative and post operative complication rate. Reintervention rate is low in those where the bPAB was performed as single procedure compared to those with concomitant procedure. Limitations of this study was that this was a retrospective study and does not compare results with classic PA bands or surgical outcomes and number of patients was relatively small. Keywords : PAB, pulmonary artery banding dilatation, pulmonary artery debanding