If a baby with VSD develops symptoms of congestive heart failure in the first few months of life, palliative surgery may be attempted. Palliative surgery reduces the symptoms of the defect without correcting the underlying cause.
PA banding is a palliative treatment particularly reserved for those patients who are unable to withstand an open heart procedure for total correction.
In the case of VSD, pulmonary artery (PA) banding increases the resistance to blood flow through the pulmonary artery. Pressure increases in the right ventricle and prevents excess shunting from left to right.
The operation consists of a thoracotomy to expose the pulmonary artery. A constrictive band is then sutured around the pulmonary artery. The PA band reduces the diameter of the PA and thereby restricts the amount of blood pumped into the lungs.
The operation reduces the blood flow from 1/2 to 1/3 of the previous volume. PA blood pressure distal to the band is reduced as a result of the volume restriction. Pulmonary artery pressure reductions of 50% to 70% are usually sought.
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