3 The procedure
3.1 Telemetric adjustable pulmonary artery banding is mainly used in infants with multiple or single ventricular septal defects and those needing left ventricular retraining for congenitally corrected transposition of the great arteries.
3.2 The procedure is done with the infant under general anaesthesia, either through a median sternotomy or lateral thoracotomy depending on the child's anatomy and the nature of their disease. The pericardium is opened over the great vessels and, with minimal dissection, a tunnel is created between the ascending aorta and the main pulmonary artery. The adjustable pulmonary artery band (which contains a micro motor) is fastened around the main pulmonary artery. The band is sutured to the pulmonary artery to prevent it from migrating. Coupling between the band and an external remote control unit (powered by an external antenna) is tested and the incision is closed.
3.3 Immediately after surgery, the infant is treated in a neonatal intensive care unit and the band is adjusted wirelessly by the control unit, according to the child's haemodynamic status, to control pulmonary artery flow. Echocardiography is used to gauge the adjustment needed. Later adjustments to the band can be done in an outpatient setting, without the need for further surgery. The band is removed at the same time as cardiac surgery for definitive repair of any heart defects.