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CC BY 4.0 · Thorac Cardiovasc Surg Rep 2025; 14(01): e19-e23
DOI: 10.1055/a-2564-2280
Case Report: Cardiac

Successful Weaning off LVAD Support in an Infant by Pulmonary Artery Banding

Maria Jaros
1   Kinderkardiologie und Pädiatrische Intensivmedizin, LMU Klinikum Abteilung für Kinderkardiologie und Pädiatrische Intensivmedizin, Munich, Germany
,
Jelena Pabst von Ohain
2   Sektion für Chirurgie angeborener Herzfehler und Kinderherzchirurgie der Herzchirurgischen Klinik, Ludwig Maximilian University of Munich, Munchen, Bayern, Germany
,
Marcus Fischer
3   Ludwig Maximilians University Munich, Munchen, Germany
,
Nikolaus Alexander Haas
4   Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-Universitat Munchen Medizinische Fakultat, Munchen, Germany
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Abstract

Background

Cardiomyopathy is the leading indication for transplantation in children. Mechanical cardiac support systems play a significant role in treating severe pediatric heart failure for cardiomyoptahy or myocarditis either for recovery or as bridge to transplant. In most cases of chronic heart failure extending over the acute inflammatory phase transplantation is necessary. Organ shortage results in a necessity for further treatment options in terminal heart failure. A new and controversially discussed approach to treat failing (left) ventricles includes pulmonary banding; In some observational studies pulmonary artery banding was performed in patients with severe (left) heart failure and adequate function of the right ventricle. The effect is postulated by improving the contra-lateral (left) ventricular function with intraventricular cross-talk and subsequent myocardial changes. Whereas selected patients may however benefit from PA banding with subsequent training of the left ventricle, nevertheless this strategy is controversially discussed.

Case Description

A 3-year-old girl with inflammatory myocarditis required left ventricular assist device (LVAD, Berlin Heart)) support. After repetitive weaning failure, pulmonary artery (PA) banding was performed during LVAD support that resulted in an improvement of the left ventricular function and finally LVAD explantation.

Conclusion

Selected patients may benefit from PA banding with subsequent training of the left ventricle even in the setting of LVAD.

This case here is the first reported case where PA banding was successful in the weaning process of a child on mechanical circulatory support (MCS). This principle of pulmonary banding to improve left ventricular function in severe heart failure can apparently also be applied to patients on left ventricular assist devices (LVAD).

Keywords

pulmonary artery banding - berlin heart - LVAD - left ventricular assist device - weaning - myocarditis in children


Publication History

Received: 01 August 2024

Accepted: 07 January 2025

Article published online:
10 June 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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