Two decades of targeted pulmonary artery banding in pediatric dilated cardiomyopathy.
7 affiliations
- 1Department of Pediatric Cardiology, Intensive Care Medicine and Congenital Heart Disease, Pediatric Heart Center, Justus-Liebig-University, Giessen, Germany.
- 2Department of Pediatric Cardiology, Goethe University, University Hospital Frankfurt, Frankfurt, Germany.
- 3Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tübingen, Tübingen, Germany.
- 4Department of Pediatric Cardiac Anesthesiology, Pediatric Heart Center, Justus-Liebig-University, Giessen, Germany.
- 5Department of Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany.
- 6Department of General and Interventional Cardiology/Angiology, Ruhr University Bochum, Heart- and Diabetescenter NRW, Bad Oeynhausen, Germany.
- 7Department of Pediatric Cardiac Surgery and Congenital Heart Disease, Pediatric Heart Center, Justus-Liebig-University, Giessen, Germany.
Abstract
Objectives
Dilated cardiomyopathy (DCM) with severe left ventricular (LV) dysfunction in infants and young children is a life-threatening condition and carries a high risk of mechanical circulatory support and heart transplantation (HTx). Pulmonary artery banding (PAB) has been proposed as a recovery strategy, but data on medium- and long-term outcomes remain limited.Methods
This retrospective, single-center observational study included infants and young children who underwent surgical PAB between 2006 and 2024. Inclusion criteria were ROSS functional class (FC) III/IV, spherical left ventricular-dilated cardiomyopathy (LV-DCM) with left ventricular ejection fraction (LVEF) <35%, and left ventricular end-diastolic diameter (LVEDD) z-score >+4 with preserved right ventricular function. Primary endpoints were overall survival and transplant-free recovery, defined as sustained normalization of LV systolic function with reverse remodeling.Results
Fifty patients (27 female) met the inclusion criteria and underwent PAB at a median age of 188 days, 70% were in ROSS FC IV, and 42% were listed as urgent for HTx. DCM etiology was idiopathic in 42%, genetic in 22%, and myocarditis-associated in 36%. There was no procedural mortality. Overall survival was 90% and 72% achieved transplant-free functional recovery. Following PAB, magnetic resonance imaging-derived LVEF improved from 19% ± 7% to 56% ± 11%, and LVEDD z-scores decreased from +6.3 to +1 (P < .001). In 33 patients, recovery was sustained over a median follow-up of 7 years, including 15 patients with stable LV function for over 10 years.Conclusions
In infants and young children with severe LV-DCM, PAB is associated with high long-term survival, sustained transplant-free recovery, and durable reverse cardiac remodeling.
Related
- Case Report: Pulmonary artery banding for an older child with end-stage dilated cardiomyopathy
- Pediatric Multiorgan Lung Transplantation: Four Decades of National Trends and Outcomes
- TOP3A pathogenic variants presenting as dilated cardiomyopathy and heart failure in three pediatric cases
- Pulmonary pressure load shapes right ventricular molecular remodelling in dilated cardiomyopathy
- Reverse Takotsubo Cardiomyopathy Complicated by Neurogenic Pulmonary Edema in Aneurysmal Subarachnoid Hemorrhage: A Case Report.
BibTeX
@article{logeswaran2026decades,
title = {{Two decades of targeted pulmonary artery banding in pediatric dilated cardiomyopathy.}},
author = {Thushiha Logeswaran and Blanka Steinbrenner and Dietmar Schranz and Sabine Recla and Karin Klingel and Matthias Müller and Kerstin Gummel and Lucie Rüblinger and Bettina Reich and Martin Farr and Christian Jux and Hakan Akintürk},
journal = {JTCVS open},
year = {2026},
month = aug,
doi = {10.1016/j.xjon.2026.102088},
url = {https://europepmc.org/article/MED/42948132},
note = {CC BY},
}
RIS
TY - JOUR
TI - Two decades of targeted pulmonary artery banding in pediatric dilated cardiomyopathy.
AU - Thushiha Logeswaran
AU - Blanka Steinbrenner
AU - Dietmar Schranz
AU - Sabine Recla
AU - Karin Klingel
AU - Matthias Müller
AU - Kerstin Gummel
AU - Lucie Rüblinger
AU - Bettina Reich
AU - Martin Farr
AU - Christian Jux
AU - Hakan Akintürk
PY - 2026
DA - 2026/08/28
JO - JTCVS open
DO - 10.1016/j.xjon.2026.102088
UR - https://europepmc.org/article/MED/42948132
AB - Objectives Dilated cardiomyopathy (DCM) with severe left ventricular (LV) dysfunction in infants and young children is a life-threatening condition and carries a high risk of mechanical circulatory support and heart transplantation (HTx). Pulmonary artery banding (PAB) has been proposed as a recovery strategy, but data on medium- and long-term outcomes remain limited.Methods This retrospective, single-center observational study included infants and young children who underwent surgical PAB between 2006 and 2024. Inclusion criteria were ROSS functional class (FC) III/IV, spherical left ventricular-dilated cardiomyopathy (LV-DCM) with left ventricular ejection fraction (LVEF) <35%, and left ventricular end-diastolic diameter (LVEDD) z-score >+4 with preserved right ventricular function. Primary endpoints were overall survival and transplant-free recovery, defined as sustained normalization of LV systolic function with reverse remodeling.Results Fifty patients (27 female) met the inclusion criteria and underwent PAB at a median age of 188 days, 70% were in ROSS FC IV, and 42% were listed as urgent for HTx. DCM etiology was idiopathic in 42%, genetic in 22%, and myocarditis-associated in 36%. There was no procedural mortality. Overall survival was 90% and 72% achieved transplant-free functional recovery. Following PAB, magnetic resonance imaging-derived LVEF improved from 19% ± 7% to 56% ± 11%, and LVEDD z-scores decreased from +6.3 to +1 (P < .001). In 33 patients, recovery was sustained over a median follow-up of 7 years, including 15 patients with stable LV function for over 10 years.Conclusions In infants and young children with severe LV-DCM, PAB is associated with high long-term survival, sustained transplant-free recovery, and durable reverse cardiac remodeling.
SN - 2666-2736
ER -