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Pulmonary Artery Banding For Pediatric Dilated Cardiomyopathy: Initial Experience
Yury Sinelnikov, MD, PhD, Mariya Pustovetova, MD, PhD, Arabbek Kayumov, MD.
Medion Innovation Clinic, Tashkent, Uzbekistan.
Objective(s): Dilated cardiomyopathy (DCM) is the leading indication for pediatric heart transplantation worldwide. Because transplantation and long-term mechanical circulatory support (such as LVAD) are currently unavailable for children in Central Asia, pulmonary artery banding (PAB) offers an alternative palliative surgical strategy to restore left ventricular (LV) geometry. We evaluate our initial experience with PAB in this cohort.
Methods: This retrospective, single-center observational study evaluated the efficacy of surgical PAB in six children (aged 6 months to 6 years) with LV DCM and preserved right ventricular (RV) function, treated between 2024 and 2025.
Results: No in-hospital mortality occurred, and clinical functional status improved in all patients. The postoperative PAB pressure gradient was 24 ± 12 mmHg. At 3 to 12 months of follow-up, the mean LV ejection fraction significantly increased from 26 ± 12% pre-PAB to 47 ± 14%. The mean LV end-diastolic volume index decreased from 150.3 ± 30.2 mL/m² to 90.2 ± 40.3 mL/m². RV function also showed improvement, with TAPSE increasing from 14 ± 4 mm to 24 ± 6 mm. Plasma B-type natriuretic peptide (BNP) levels decreased from a baseline of 1711 ± 833.21 pg/mL to 1048 ± 318.4 pg/mL at discharge, and further down to 524 ± 821.71 pg/mL at 12 months.
Conclusions: In young children with LV dilated cardiomyopathy and preserved RV function, PAB significantly improves left ventricular performance and remodeling, likely mediated by favorable ventricular-ventricular interactions. It represents a viable palliative option where transplantation is inaccessible.
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