Key result
Pulmonary artery banding improves symptoms to NYHA I in pediatric dilated cardiomyopathy despite persistent LV dysfunction.
Why the study?
Therapeutic options for children with end-stage dilated cardiomyopathy are limited and experience with pulmonary artery banding in older children is scarce.
Case Report (n=1)
No
Pulmonary artery banding provided short-term symptomatic improvement in an older child with end-stage dilated cardiomyopathy, though the delayed intervention may have limited substantial myocardial reverse remodeling.
May improve symptoms without restoring function in older children; leaves open its role as bridge therapy pending prospective trials.
Therapeutic options for children with end-stage dilated cardiomyopathy are limited. Pulmonary artery banding has been proposed as a potential bridge or alternative strategy in children with severe left ventricular dysfunction and preserved right ventricular function, but related experience in older children is limited. We report a 5.5-year-old girl diagnosed with dilated cardiomyopathy who showed progressive left ventricular dilation and persistent systolic dysfunction despite long-term medical therapy. Preoperative echocardiography showed left ventricular end-diastolic diameter (LVEDD) of 64.4 mm, Z-score of +9.7, and left ventricular ejection fraction (LVEF) of 25.0%, while cardiac magnetic resonance imaging (CMR) demonstrated relatively preserved right ventricular systolic function. Pulmonary artery banding was performed without major perioperative complications. At 4-month follow-up, her clinical symptoms improved from NYHA class II to class I; however, echocardiography showed persistent reverse remodeling, with an LVEF of 25.7% and an LVEDD Z-score of +8.8. This case suggests that PAB may provide symptomatic benefit in older children with end-stage DCM but that delayed intervention may limit myocardial recovery.
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Huang et al. (2026) conducted a case report in End-stage dilated cardiomyopathy (n=1). Pulmonary artery banding was evaluated on Clinical symptoms (NYHA class) and echocardiographic parameters (LVEF and LVEDD). Pulmonary artery banding improved clinical symptoms from NYHA class II to class I in a 5.5-year-old girl with end-stage dilated cardiomyopathy, although left ventricular dysfunction persisted with limited reverse remodeling.
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