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December 1969

Pulmonary Artery Hypertension in Infants With Congenital Heart Disease: Palliative Management by Pulmonary Artery Binding

Author Affiliations

From the departments of surgery (Drs. Boruchow and Waldhausen) and pediatrics (Cardiology) (Drs. Miller, Rashkind, and Friedman), University of Pennsylvania School of Medicine and the Children's Hospital of Philadelphia, Philadelphia.

Arch Surg. 1969;99(6):716-722. doi:10.1001/archsurg.1969.01340180040007

The management of infants with congenital heart disease and pulmonary hypertension with increased pulmonary blood flow has remained a challenge to both the cardiologist and the surgeon. The mortality in this group remains high despite a better understanding of the natural history of such lesions and the availability of various operative approaches. Controversy exists concerning the use of early total correction,1 palliation by pulmonary artery constriction,2 or medical management alone. During the past three years we have employed an aggressive approach toward pulmonary artery hypertension in infants by the application of pulmonary artery banding. The present report deals with the results of this method of management. Also included are a few patients operated upon prior to this time.

Clinical Material and Methods  The 40 infants treated ranged in age from seven days to 24 months (Table 1). Over half of these were under 6 months old and 72%

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