Why the study?
Does pulmonary artery banding followed by complete repair improve survival in patients with late-presenting complete atrioventricular canal?
Does pulmonary artery banding followed by complete repair improve survival in patients with late-presenting complete atrioventricular canal?
In late-presenting complete atrioventricular canal with severe reactive pulmonary hypertension, initial pulmonary artery banding followed by delayed complete repair is associated with low mortality and good functional outcomes.
May support staged repair in select late presenters; hypothesis-generating and should not yet change practice.
Primary repair of complete atrioventricular canal in patients who present beyond one year of age carries a high mortality. Between January 1995 and February 2000, 16 patients aged 8 to 24 months (mean, 14.5 months) received pulmonary artery banding at presentation and underwent total correction at 24 to 96 months old (mean, 41.9 months). There was one hospital death (mortality, 6.25%). During a mean follow-up of 10.2 months (range, 6 to 28 months), there was no late death, 13 of the 15 survivors (87%) were in New York Heart Association functional class I, and 2 (13%) were in class III. In patients with complete atrioventricular canal who present late with severe reactive pulmonary hypertension, banding followed by complete repair reduces the risk associated with primary repair.
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Qethamy et al. (2002) studied this question.
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