Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Cardiothoracic Surgery

Background: Among the complications noted after debanding is those relatedto residual pulmonary stenosis. Some studies show that the removal of band without repairing pulmonary artery could be enough. Other studies recommend patching of the pulmonary artery at the site of the band during debanding because of the possibility of residual gradient caused by a residual shelf or narrowing and distortion of the arterial wall.This may necessitate re-operation especially if it leads to pressure over-load on the right ventricle Patients and methods: This retrospective observational study included 40 patients who underwent pulmonary artery debanding in the period between January 2016 and January 2020 at the cardiothoracic surgery department of Cairo University hospitals and Atfal Masr Hospital. Patients were divided into two groups; group A which included 20 patients who underwent simple band removal and group B which included 20 patients who underwent pulmonary artery debanding with pericardial patch repair. Results:The median pressure gradient across the main pulmonary artery postoperatively was 15 mm Hg for group A (mean 22.58 ± 18.0) and 10 mm Hg for group B (mean 11.3 ± 8.0) with statistically significant value (p = 0.020). 40.0% of cases in Group A had significant residual pressure gradient compared to only 10.0% of cases in Group B, and that difference was statistically significant (p=0.028).The median pressure gradient across the band immediate preoperatively was 60 mm Hg for group A (mean 62.0 ± 9.8) and 70 mm Hg (mean 64.2 ± 10.6) with statistically insignificant value (p = 0.065)

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