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DOI: 10.1055/s-2006-925677
FloWatch®: Telemetrically adjustable pulmonary artery banding
Objectives: Complex congenital heart defects may require pulmonary artery banding (PAB) to control pulmonary blood flow/pressure or re-train the left ventricle. With conventional PAB re-operations are often required to adjust pulmonary blood flow/pressure and ICU stays can be prolonged. We report the first UK experience with the telemetrically adjustable PAB FloWatch®.
Methods: Eleven infants, mean age 2.7 months (7 days to 6 months), mean weight 4.2kg (3.1 to 5.2kg) underwent implantation of FloWatch® through median sternotomy in 10 and left thoracotomy in 1. Diagnosis was complex/multiple ventricular septal defects (VSDs) (6), transposition of the great arteries (TGA) (2), atrio-ventricular septal defect (1), congenitally Corrected TGA (1), and mitral atresia (1). Four infants had a previous cardiac operation.
Results: Neither death nor device-related complication occurred during a mean follow-up of 8.4 months (1 to 21 months). There was one death (1/11=9%) three months after surgery (sepsis). Mean duration of post-operative mechanical ventilation was 2.9 days versus 8.5 days in a homologous group of infants with conventional PAB. A mean of 4.4 adjustments/patient were required, in 92% of cases (44/48) to narrow the pulmonary artery, in 8% (4/48) to release it. Three infants had successful removal of the device at repair (two with an arterial switch operation).
Conclusion: The device allows optimal adjustment of the pulmonary artery flow/pressure. This technology may obviate the need for re-operations and shorten the stay in ICU, and appears a suitable surgical option for left ventricular re-training.