Treatment of Ventricular Septal Defect by Constriction of Pulmonary Artery

Abstract

In certain infants with ventricular septal defect and severe pulmonary hypertension, intensive nonoperative management fails to control the progression of cardiac failure.^2,4-6,8,14Definitive operation for closure of the defect in these seriously ill infants has been so lethal in the experience of most surgeons that a palliative constriction of the pulmonary artery has been preferred.^1-3,9,12,13We have employed this "pulmonary banding," introduced by Muller and Dammann¹⁰in 23 patients, most of whom were infants under the age of 12 months with tentative diagnosis of ventricular septal defect or other lesion giving pulmonary hypertension. Because the procedure is admittedly a temporizing measure in preparation for a subsequent definitive operation, final assessment of its worth must await the results of complete repair by this staged approach.^7,12Meanwhile, it seems desirable to report on the status of those infants who have undergone pulmonary arterial constriction as the first phase