Evidence of pulmonary vascular reverse remodeling after pulmonary artery banding performed in early infancy in patients with congenital heart defects

Naoki Masaki, Yuriko Saiki, Masato Endo, Kay Maeda, Osamu Adachi, Masatoshi Akiyama, Shunsuke Kawamoto, Yoshikatsu Saiki

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Histomorphometric evidence of the effect of pulmonary artery banding (PAB) in infancy on pulmonary vascular reverse remodeling has not been fully described. Methods and Results: We retrospectively reviewed 34 patients who underwent serial lung biopsies before and after PAB. Index of pulmonary vascular disease (IPVD) as a measure of the degree of progression of pulmonary arteriopathy significantly decreased after PAB (1.22±0.25 at 1st and 1.13±0.21 at 2nd biopsy, P=0.04). Additionally, DR=100 µm as an indicator of medial thickness of pulmonary arteries significantly decreased after PAB (15.6±3.7 at 1st and 11.4±2.6 at 2nd biopsy, P<0.0001). Patients were divided into 3 groups by age at PAB: <3 months (Group 1), between 3 and 6 months (Group 2), and >6 months (Group 3). The average second DR=100 µm of groups 1 and 2 was significantly lower than that of group 3 (11.1±2.2 and 9.8±2.0 vs. 14.9±2.8, respectively; P<0.0001). Additionally, the second IPVD was also significantly lower in groups 1 and 2 than in group 3 (1.1±0.2 and 1.1±0.2 vs. 1.3±0.4, respectively; P=0.02). Conclusions: Histomorphometric evidence of post-PAB pulmonary vascular reverse remodeling is robust. The magnitude of vascular reversibility is pronounced when PAB is performed before 6 months of age.

Original languageEnglish
Pages (from-to)684-690
Number of pages7
JournalCirculation Journal
Volume82
Issue number3
DOIs
Publication statusPublished - 2018 Jan 1

Keywords

  • Congenital heart defects
  • Pulmonary arteriopathy
  • Pulmonary artery banding
  • Reverse remodeling

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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