Pulmonary artery banding and subsequent repair in ventricular septal defect.

or complicated ventricular septal defects. The main indication for the procedure was intractable congestive cardiac failure not responding to medical therapy. There was a I2 per cent mortality. Complications resulting from the operation are recorded. Twenty of these children have subsequently undergone repair of the ventricular septal defect and reconstruction of the pulmonary artery with a mortality of 30 per cent. To reduce these high risks, the second operation should be performed as early as possible, before secondary changes have resulted from the presence of the band. In the near future the operative mortality should be more acceptable when primary repair is undertaken in infants under the age of 6 months, using profound hypothermia. Primary repair is certainly preferable to banding for patients over 6 months of age.