Removal of pulmonary artery band.

From 1963 to September 1973, 60 patients underwent definitive repair of cardiac lesions for which pulmonary artery banding had been performed previously. Most bandings had been performed for intractable heart failure secondary to large pulmonary flow. The pulmonary artery band resulted in a fibrous reaction around the pulmonary artery or its branches in all instances. Angioplastic procedures on the main pulmonary artery or the left and right pulmonary arteries were usually necessary to relieve the stenosis produced by the band and the resultant scarring. The operative mortality in this group of patients was 28% and pulmonary artery banding was considered to be a factor in 4 of the 17 deaths. The absence of absolute protection from the development of progressive pulmonary vascular disease, the mortality associated with banding, and the mortality and increased technical difficulties associated with removing the band at the time of the repair support one-stage definitive procedures rather than palliative banding of the pulmonary arteries in all but the most exceptional situations.