الفهرس 
Anatomy of Congenital Cardiac Diseases (CHDs)Only 14 pages are availabe for public view
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Abstract
ABSTRACT
Background: Pulmonary artery banding (PAB) remains a useful surgical palliation for small neonates and early infants with excessive pulmonary blood flow who are unable or difficult to withstand an open heart surgery using cardiopulmonary bypass or in developing countries where the facilities not suitable for primary corrective surgery in those infants.
Objectives: In our current study we aimed to study clinical pathway of cases underwent PAB at ASU hospital pediatric cardiac surgery department with comparison between extubated vs. non extubated on table patients regarding postopertaive clinical pathway.
Patients and Methods: Study done by data collection retrospectively of 50 patients underwent pulmonary artery banding in the period from January 2018 to December 2019 who fulfilling the inclusion criteria with evaluation of different clinical pathways for the outcome mainly morbidities and mortality
. Results: We found that the major risk factor of mortality in cases underwent PAB in ASU hospitals is ventilation , In our study 31 cases among 50 were extubated on table by comparison of their post operative clinical pathway to other group of 19 patients non extubated we found that there is strong relation between non extubated group to mortality , low early post operative PG across band , prolonged ICU stay , morbidites mostly chest infection , lung collapse so we recommend to extubate patients post PAB as soon as possible to avoid these comorbidities and mortality.
Conclusion: We found that best clinical pathway in management of infants underwent PAB is to adjust intra operative band tightness according to targeted oxygen saturation (so2) on minimal ventilation settings and according to trusler formula whether infant planned for univentricular or biventricular repair . To Extubate those patients on table intraoperative or shortly after their discharge to ICU . It is preferred to discharge most of those patients on inotropic support dobutrex to get its benefit as inodilator to improve RV function and relief pulmonary hypertention.