Late banding operation in children with ventricular septal defect and pulmonary arterial hypertension.

Since 1960 31 children, 2-10 years old, with large ventricular septal defects and pulmonary arterial hypertension, underwent pulmonary artery banding in Munich. 22 of these children were recatheterized 3-5 years after the operation. Only 8 of these children were shown to have a definite decrease in pressure distal to the band, and in only 2 of these children a reduction of pulmonary vascular resistance to values at the upper limit of normal could be shown. In the remaining children either little or no alteration and rarely even a definite increase of pulmonary vascular resistance was found. There was only a poor correlation between pressure changes and resistance changes. During preoperative catheterization oxygen breathing was shown to produce a more than 50% reduction in the pulmonary arterial pressure in 8 cases. Of these, only 5 showed a decrease of pulmonary vascular resistance after pulmonary artery banding. This decrease, however, was relatively small.