Abstract
Background: Pulmonary artery banding is a palliative surgical procedure used as a staged-approach to operative correction of congenital heart defects leading to right ventricular volume overload and pulmonary hypertension. This study was carried to find out effectiveness of two-stage procedure of VSD closure following PA-banding in congenital VSD and significant pulmonary hypertension. Material & Methods: This descriptive study was carried out at Rehman Medical Institute, Peshawar, from January 2003 to March 2012. Record of patients having congenital VSD with significant pulmonary hypertension who underwent two-stage operation (PA-banding followed by VSD-closure), was studied. Results: Forty-five patients with congenital VSD and severe pulmonary hypertension underwent PA-banding. Out of these, 33 patients had subsequent PA-debanding and VSD-closure. Male to female ratio was 2:1 (22 males: 11 females). Among these, 30(90.90%) patients had successful VSD-repair, while 3(9.09%) patients died. The median interval between PA-banding and VSD-closure was 2.05 years. The morbidity included one patient having MPA bleed during PA-banding which was immediately repaired and another patient had CVA post-VSD repair which improved during follow-up. Follow-up was available in 29/30 (96.67%) successfully repaired VSD patients. It ranged 2-5 years, with mean 2 years and 9 months. No recurrence was observed during the follow-up. Conclusion: In congenital VSD associated with severe pulmonary hypertension, two-stage repair is safe and effective technique with acceptable morbidity and mortality.

Muhammad Aasim, Amir Mohammad, Niaz Ali, Mohammad Zahidullah, Mumtaz Anwar, Raheela Aasim, Sumayya Rehman, Muhammad Rehman. (2014) VSD CLOSURE FOLLOWING PULMONARY ARTERY BANDING IN CONGENITAL VSD WITH SIGNIFICANT PULMONARY HYPERTENSION, Gomal Journal of Medical Sciences , Volume 12, Issue 1.
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