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  • Title: FloWatch versus conventional pulmonary artery banding.
    Author: Corno AF, Ladusans EJ, Pozzi M, Kerr S.
    Journal: J Thorac Cardiovasc Surg; 2007 Dec; 134(6):1413-9; discussion 1419-20. PubMed ID: 18023654.
    Abstract:
    OBJECTIVE: We sought to compare the efficacy of conventional pulmonary artery banding with that of FloWatch pulmonary artery banding. METHODS: Forty consecutive infants underwent conventional pulmonary artery banding (n = 20; mean age, 1.8 +/- 1.5 months; mean weight, 3.7 +/- 0.7 kg) or FloWatch pulmonary artery banding (n = 20; mean age, 2.6 +/- 1.3 months; mean weight, 4.1 +/- 0.8 kg). Indications were preparation for biventricular repair in 16 of 20 infants, univentricular repair in 2 of 20 infants, and left ventricular retraining in 2 of 20 infants in the conventional pulmonary artery banding group versus 13 of 20, 5 of 20, and 2 of 20 infants, respectively, in the FloWatch pulmonary artery banding group. Twelve of 20 infants required preoperative mechanical ventilation in the conventional pulmonary artery banding group (mean duration, 3.3 +/- 4.3 days) versus preoperative mechanical ventilation required by 14 of 20 in the FloWatch pulmonary artery banding group (mean duration, 17.5 +/- 19.0 days; P < .005). RESULTS: There were 3 early and 2 late deaths after conventional pulmonary artery banding (mean follow-up, 10.8 +/- 9.6 months; range, 1-33 months) versus no early and 2 late deaths after FloWatch pulmonary artery banding (mean follow-up, 13.4 +/- 10.4 months; range, 1-38 months). Postoperative mechanical ventilation and intensive care unit and hospital stays were significantly longer after conventional pulmonary artery banding than those after FloWatch pulmonary artery banding, respectively (10.4 +/- 11.2 vs 3.0 +/- 3.1 days [P < .01], 20.3 +/- 19.9 vs 5.3 +/- 4.6 days [P < .005], and 45.6 +/- 41.6 vs 15.4 +/- 6.4 days [P < .005]). Reoperation to adjust the band was required in 7 (35%) of 20 infants after conventional pulmonary artery banding, whereas no reoperations were required after FloWatch pulmonary artery banding (P < .005). Average cost of stay in the intensive care unit and hospital was, respectively, $45,000 and $45,300 cheaper with FloWatch pulmonary artery banding than average cost with conventional pulmonary artery banding, largely surpassing the cost of the device ($10,000). CONCLUSIONS: FloWatch pulmonary artery banding appears superior to conventional pulmonary artery banding because (1) reoperations are not required; (2) postoperative management is simplified and postoperative mechanical ventilation, stay in the intensive care unit, and stay in the hospital are significantly reduced; and (3) the reduction in costs of postoperative mechanical ventilation, stay in the intensive care unit, and stay in the hospital significantly outweigh the cost of the device.
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