Biventricular response to pulmonary artery banding in children with dilated cardiomyopathy

‘End-stage’ heart failure therapy: potential lessons from congenital heart disease: from pulmonary artery banding and interatrial communication to parallel circulation

“…The current results, partially published, 16 can be seen as ‘proof-of-principle’ data obtained in currently 35 infants and young children: 31 procedures were successful, while 4 children did not show any response. Thus, rPAB in LV failure may provide a novel alternative for ‘bridge-to-transplant’ or destination therapy in children with advanced LV-DCM; in addition, nowadays there are also some successful case experiences with PAB in LV-DCM in several other centres worldwide.…”

“…Considering our currently only partially published institutional experience of percutaneous left atrial decompression, 25 creating a restrictive atrial septum defect (rASD) is safe and technically feasible at any age. Restriction of the interatrial communication preserves an adequate filling pressure for diastolic and/or systolic dysfunctional systemic ventricles, but clinical symptoms related to the ‘out-of-proportion’ left atrial and pulmonary pressures can significantly be influenced.…”

Case report and review of the literature: the utilisation of a ventricular assist device as bridge to recovery for anthracycline-induced ventricular dysfunction

“…In addition to standard medical management, mechanical circulatory support, and cardiac transplantation, a variety of other therapeutic strategies have been studied that may be applicable to selected patients with heart failure. 20,21 These strategies include first, reversible pulmonary artery banding in left ventriculardilated cardiomyopathy with preserved right ventricular function; second, the creation of restrictive inter-atrial communication; third, atrioseptostomy or reverse Potts shunt in pulmonary arterial hypertension; and finally, return to a foetal, parallel circulation by combining atrioseptostomy and reversed Potts shunt with or without placement of a bilateral pulmonary artery banding. Although all of these novel approaches may be beneficial in select patients, the mainstay of therapy for cardiac failure in children and adults is medical management, mechanical circulatory support, and cardiac transplantation.…”

Pulmonary Artery Banding for Children With Dilated Cardiomyopathy: US Experience

“…While it is definitely not an overstatement to say that there are a certain proportion of children with DCM who would benefit from PAB, currently there remain various "unknowns" regarding PAB for DCM, which pose a significant challenge to optimizing patient selection for this strategy. In particular, despite the proposed multiple mechanisms, such as improvement in LV systolic strain and reduced mitral regurgitation, 3 the exact reason why PAB improves heart failure with DCM is largely unknown. Without a clear understanding in the mechanisms, the efficacy of PAB is hard to predict.…”

“…Conceptually, such a septal shift may reduce LV volume and mitral regurgitation, and restore ventricular electromechanical synchrony. 2,3 The initial report from Germany primarily focused on the use of PAB for cardiac recovery. 1 Subsequent case series have shown the potential utility of PAB as a tool for bridge-to-ventricular assist device (VAD) or straight to heart transplant.…”