Although pulmonary artery banding remains a useful palliation in bi-ventricular shunting lesions, single-stage repair holds several advantages. We investigate outcomes of the former approach in high-risk patients.

Retrospective cohort study including all pulmonary artery banding procedures over 9 years, excluding single ventricle physiology and left ventricular training.

Banding was performed in 125 patients at a median age of 41 days (2–294) and weight of 3.4 kg (1.8–7.32). Staged repair was undertaken for significant co-morbidity in 81 (64.8%) and anatomical complexity in 44 (35.2%). The median hospital stay was 14 days (interquartile range 8–33.5) and 14 patients (11.2%) required anatomical repair before discharge. Nine patients died during the initial admission (hospital mortality 7.2 %) and five following discharge (inter-stage mortality 4.8%). Of 105 banded patients who survived, 19 (18.1%) needed inter-stage re-admission and 18 (14.4%) required unplanned re-intervention. Full repair was performed in 93 (74.4%) at a median age of 13 months (3.1–49.9) and weight of 8.5 kg (3.08–16.8). Prior banding, 54% were below the 0.4th weight centile, but only 28% remained so at repair. Post-repair, 5/93 (5.4%) developed heart block requiring permanent pacemaker, and 11/93 (11.8%) required unplanned re-intervention. The post-repair mortality (including repairs during the initial admission) was 6/93 (6.5%), with overall mortality of the staged approach 13.6% (17/125).

In a cohort with a high incidence of co-morbidity, pulmonary artery banding is associated with a significant risk of re-intervention and mortality. Weight gain improves after banding, but heart block, re-intervention, and mortality remain frequent following repair.

尽管肺动脉束带仍然是双心室分流病变的有效缓解方法，但单阶段修复具有几个优点。我们研究了前一种方法在高危患者中的结果。

回顾性队列研究包括 9 年以上的所有肺动脉束带手术，不包括单心室生理学和左心室训练。

125 名患者接受了束带术，中位年龄为 41 天（2-294），体重为 3.4 kg（1.8-7.32）。针对 81 例 (64.8%) 的严重合并症和 44 例 (35.2%) 的解剖复杂性进行了分期修复。中位住院时间为 14 天（四分位数范围 8-33.5），14 名患者（11.2%）在出院前需要进行解剖修复。9 名患者在初次入院期间死亡（医院死亡率 7.2%），5 名患者在出院后死亡（分期死亡率 4.8%）。在 105 名幸存的带状患者中，19 名 (18.1%) 需要分期重新入院，18 名 (14.4%) 需要计划外重新干预。93 例 (74.4%) 患者接受了完全修复，中位年龄为 13 个月 (3.1-49.9)，体重为 8.5 公斤 (3.08-16.8)。之前的条带中，54% 的体重低于 0.4 个百分位，但修复后只有 28% 保持在这个水平。修复后，5/93 (5.4%) 的患者出现心脏传导阻滞，需要永久起搏器，11/93 (11.8%) 的患者需要计划外的再次干预。修复后死亡率（包括初次入院期间的修复）为 6/93 (6.5%)，分阶段方法的总体死亡率为 13.6% (17/125)。

在合并症发生率高的队列中，肺动脉束带与再次干预和死亡的显着风险相关。束带术后体重增加有所改善，但修复后心脏传导阻滞、再次干预和死亡仍然频繁发生。