Midterm Outcomes of Endovascular Pulmonary Artery Debanding in Children

Pulmonary artery banding (PAB) palliates pulmonary over-circulation, while endovascular debanding (ED) offers a less invasive alternative to repeat surgery. To evaluate our experience with ED. Retrospective review of single-center data (2015-2023) on children with single, multiple, or "Swiss-cheese" muscular ventricular septal defects (MVSDs) undergoing ED. Ten patients (50% male) underwent ED at a median age of 5 years (IQR, 1.8-6.8) and weight of 15 kg (IQR, 10.6-19.7). Four patients had single MVSD, six had multiple MVSDs. Debanding occurred at a median of 52.8 months (IQR, 18.4-76.6) post-PAB, utilizing six non-compliant Numed Z-MED and four semi-compliant Balt Cristal high-pressure balloons. Median pulmonary valve annulus (PVA) diameters were 15.5 mm (IQR, 12.5-16.8) angiographically. Median balloon-to-PVA diameter ratio was 1 (IQR, 1-1), and median balloon-to-band diameter ratio was 2 (IQR, 1.8-2). Median trans-PAB gradient decreased from 100 mmHg (IQR, 86-108) to 40 mmHg (IQR, 26-46) (p