Flow Measurements Help Predict Outcomes of Kids’ Pulmonary Artery Banding
Pulmonary artery banding (PAB) has been the standard treatment for patients with high pulmonary blood flow who are awaiting subsequent surgery. The band is designed to provide adequate systemic flow to the body by restricting pulmonary flow. This allows the patient to grow and therefore become a better candidate for follow-up surgery.
In the study, the cases of 12 patients who underwent a PAB were reviewed and aortic and pulmonary measurements of aortic and PA flows were made directly on the vessels with an 8mm or 10mm Transonic Flowprobe both before and after banding.
The surgeons found that the efficacy of the banding procedure related directly to the percentage increase in aortic blood flow measured intraoperatively. The three patients with less than 20% increase in aortic blood flow died, required re-PAB or developed ventricular dysfunction. Patients with successful banding had more than 40% increase in aortic blood flow.
Researchers also discovered that the percentage increase in aortic blood flow was not predictable based on pre-band or post-band absolute aortic blood flow measurements. It was inversely correlated to the tightness of the band.
The clinicians identified the change in the aortic blood flow as a new, physiologically based parameter to help predict PAB outcome and suggest that assessment of the change in aortic blood flow is a useful tool to determine the circulatory response to pulmonary artery band physiology.