Interpretation of the echocardiographic pressure gradient across a pulmonary artery band in the setting of a univentricular heart

  • Shane M. Tibby
  • Andrew Durward


Pulmonary artery (PA) banding has been established as a palliative surgical technique for congenital heart defects for over 50 years [1]. With the advent of earlier corrective surgery, the indications for PA banding have changed over time [2, 3]. Currently these include: (a) limitation of pulmonary blood flow in the setting of an excessive left-toright shunt; (b) regulation of pulmonary blood flow in the univentricular circulation; and (c) a training procedure for the left ventricle prior to conversion to the systemic pumping chamber (late presentation of D-transposition of the great arteries, or prior to a double-switch procedure with L-transposition).


Oxygen Saturation Hypoplastic Left Heart Syndrome Arterial Oxygen Saturation Pulmonary Artery Band Central Venous Oxygen Saturation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Muller Jr WH, Danimann Jr JF. The treatment of certain congenital malformations of the heart by the creation of pulmonic stenosis to reduce pulmonary hypertension and excessive pulmonary blood flow; a preliminary report. Surg Gynecol Obstet. 1952;95:213–219.PubMedGoogle Scholar
  2. 2.
    Corno AF. Pulmonary artery banding. Swiss Med Wkly. 2005;135:515–519.PubMedGoogle Scholar
  3. 3.
    Plunkett M, Laks H. Pulmonary Artery Banding. E-medicine accessed 28 March 2007
  4. 4.
    Granton JT, Rabinovitch M. Pulmonary arterial hypertension in congenital heart disease. Cardiol Clin. 2002;20:441–457.PubMedCrossRefGoogle Scholar
  5. 5.
    Pinho P, von Oppell UO, Brink J, Hewitson J. Pulmonary artery banding: adequacy and long- term outcome. Eur J Cardiothorac Surg. 1997;11:105–111.PubMedCrossRefGoogle Scholar
  6. 6.
    Fyfe DA, Currie PJ, Seward JB, Tajik AJ, Reeder GS, Mair DD, Hagler DJ. Continuous-wave Doppler determination of the pressure gradient across pulmonary artery bands: hemodynamic correlation in 20 patients. Mayo Clin Proc. 1984;59:744–750.PubMedGoogle Scholar
  7. 7.
    Wernovsky G, Bove EL. Single ventricle lesions. In: Chang AC, Hanley FL, Wernovsky G, Wessel DL, editors. Pediatric cardiac intensive care. Philadelphia: Lippincott Williams and Wilkins; 1998. p. 275–276.Google Scholar
  8. 8.
    Corno AF. Revised pulmonary artery banding. Ann Thorac Surg. 2000;69:1295–1296.PubMedCrossRefGoogle Scholar
  9. 9.
    Barnea O, Austin EH, Richman B, Santamore WP. Balancing the circulation: theoretic optimization of pulmonary/systemic flow ratio in hypoplastic left heart syndrome. J Am Coll Cardiol. 1994;24:1376–1381.PubMedCrossRefGoogle Scholar
  10. 10.
    Charpie JR, Dekeon MK, Goldberg CS, Mosca RS, Bove EL, Kulik TJ. Postoperative hemodynamics after Norwood palliation for hypoplastic left heart syndrome. Am J Cardiol. 2001;87:198–202.PubMedCrossRefGoogle Scholar
  11. 11.
    Taeed R, Schwartz SM, Pearl JM, Raake JL, Beekman III RH, Manning PB, Nelson DP. Unrecognized pulmonary venous desaturation early after Norwood palliation confounds Gp:Gs assessment and compromises oxygen delivery. Circulation. 2001;103:2699–2704.PubMedGoogle Scholar
  12. 12.
    Albus RA, Trusler GA, Izukawa T, Williams WG. Pulmonary artery banding. J Thorac Cardiovasc Surg. 1984;88:645–653.PubMedGoogle Scholar
  13. 13.
    Rivers EP, Ander DS, Powell D. Central venous oxygen saturation monitoring in the critically ill patient. Curr Opin Crit Care. 2001;7:204–211.PubMedCrossRefGoogle Scholar
  14. 14.
    Li J, Zhang G, McCrindle BW, Holtby H, Humpl T, Cai S, Caldarone CA, Redington AN, Van Arsdell GS. Profiles of hemo- dynamics and oxygen transport derived by using continuous measured oxygen consumption after the Norwood procedure. J Thorac Cardiovasc Surg. 2007;133:441–448.PubMedCrossRefGoogle Scholar
  15. 15.
    Akintuerk H, Michel-Behnke I, Valeske K, Mueller M, Thul J, Bauer J, Hagel KJ, Kreuder J, Vogt P, Schranz D. Stenting of the arterial duct and banding of the pulmonary arteries: basis for combined Norwood stage I and II repair in hypoplastic left heart. Circulation. 2003;105:1099–1103.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Shane M. Tibby
    • 1
  • Andrew Durward
    • 1
  1. 1.Paediatric Intensive Care UnitEvelina Children’s Hospital, Guy’s and Saint Thomas’ NHS TrustLondonUK

Personalised recommendations