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Eur J Cardiothorac Surg 2003;23:317-322
© 2003 Elsevier Science NL

Pulmonary artery banding: long-term telemetric adjustment

^a Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), 46 rue du Bugnon, CH-1011, Lausanne, Switzerland
^b Pediatric Cardiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
^c Anaesthesia, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland

Received 10 September 2002; received in revised form 25 November 2002; accepted 27 November 2002.

^* Corresponding author. Tel.: +41-21-314.2280; fax: +41-21-314.2278
e-mail: antonio.corno{at}chuv.hospvd.ch

Objective: Adjustment of pulmonary blood flow is difficult in pulmonary artery banding for complex congenital heart defects. A new wireless, battery free, telemetrically controlled, implantable device (FloWatch^TM, EndoArt, S.A., Lausanne, Switzerland) allowing for progressive occlusion/reopening of the device through a remote control at the wanted percentage of occlusion (adjustable pulmonary artery banding) underwent experimental evaluation. Methods: Eleven mini-pigs underwent FloWatch^TM implantation around the main pulmonary artery through left thoracotomy. The first group (n=4), mean age 18.2±0.1 weeks, mean body weight 12.0±0.1 kg, underwent FloWatch^TM implantation as device tolerance test. The second group (n=7), mean age 8.6±3.4 weeks, mean body weight 5.1±1.5 kg, underwent functional evaluation: at implantation, 1, 3, 5, 8 and 10 weeks after implantation, the device was progressively occluded and reopened, with Doppler evaluation of the developed pressure gradient. Results: The four mini-pigs of first group were sacrificed at mean age of 42.3±0.1 weeks, mean body weight 25.1±3.2 kg (mean interval of 24 weeks after implantation); the device was still functioning and histology revealed almost normal morphology of the pulmonary artery. In all seven mini-pigs of second group the possibility of narrowing/releasing the pulmonary artery was confirmed at implantation and during follow-up: at last control their mean age was 20.5±2.8 weeks and the body weight 12.7±3.7 kg. Conclusions: Complete adjustment of pulmonary blood flow is now possible with an implantable device allowing for pulmonary artery banding with early and late telemetric flow control.

Key Words: Adjustable device • Congenital heart defects • Congenital heart surgery • Palliative procedure • Pulmonary artery banding • Pulmonary hypertension

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