• Muhammad Aasim

• Amir Mohammad

• Niaz Ali

• Mohammad Zahidullah

• Mumtaz Anwar

• Raheela Aasim

• Sumayya Rehman

• Muhammad Rehman

تلخیص

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.

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