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The Annals of Thoracic Surgery, Vol 41, 65-69, Copyright © 1986 by The Society of Thoracic Surgeons
E Solis, CF Heck, JB Seward and MP Kaye
Conventional banding techniques result in up to 50% mortality as a result
of improper and fixed constriction of the pulmonary artery in patients in
unstable condition. We developed a percutaneously adjustable band with a
fluid-filled reservoir that allows variable constriction without
thoracotomy or other surgical procedures. Six pigs ranging in weight from 7
to 10 kg underwent pulmonary artery banding. Swan-Ganz catheterization,
ultrasound studies, and Doppler studies were used to adjust and monitor the
pressure gradient across the band. Thirty days after banding, the pigs were
killed; their hearts were sectioned, weighed, and compared with hearts from
a control group of six pigs weighing 11 to 13 kg. The ratio of mean total
heart weight to total body weight (X 10(-3] was 6.3 +/- 0.7 in the banded
group and 4.4 +/- 0.3 in the controls (p less than 0.001). The ratio of
left ventricular weight to right ventricular weight was 0.76 +/- 0.1 in the
banded group and 1.6 +/- 0.1 in the controls (p less than 0.001). The
thickness of the right ventricular free wall was 4.9 +/- 0.5 mm in the
banded group and 2.6 +/- 0.5 mm in the controls (p less than 0.001). Right
ventricular free wall weight in the banded group was 25.9 +/- 5.8 gm
compared with 11.1 +/- 1.3 gm in the controls (p less than 0.001). These
results demonstrate the effectiveness of the band in inducing right
ventricular hypertrophy. Since the band is easily placed and simply
adjusted percutaneously, this device promises to be of importance
clinically in improving the safety of pulmonary artery banding procedures.
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Percutaneously adjustable pulmonary artery band
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