Work

Two decades of targeted pulmonary artery banding in pediatric dilated cardiomyopathy

Year: 2026

Type: article

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: < .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.

Source: JTCVS Open

DOI: 10.1016/j.xjon.2026.102088