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Abstract The role of pulmonary artery banding (PAB) is to reduce pulmonary blood overflow in order to prevent or reverse cardiac failure and to provide long-term protection against irreversible pulmonary hypertension, as well as to maintain an optimal systemic output in cases of a large left-to-right shunt or univentricular heart defects. Moreover, preparation and ‘training’ of the left ventricle (LV) is mandatory in patients with complete transposition of the great arteries (TGA) with late referral or delayed arterial switch procedure. Patients with congenitally corrected TGA may benefit from PAB as a staged procedure for LV retraining towards a ¬double-switch operation. Since the 1980s, survival of neonates and infants with complex cardiac defects and congestive heart failure (CHF) caused by large VSDs, tricuspid atresia and other complex lesions unsuitable for primary repair has been significantly improved by the use of PAB. Although the use of PAB has declined during the last decade, in favor of early and primary repair, it still has a place in the treatment of congenital heart disease with pulmonary overflow. Nevertheless, some issues are still under discussion, such as the degree of optimal tightness of the band, the ways to monitor the degree of tightness, the presence of -individual variations in ventricular adaptive response, the optimal timing of de-banding and the need for reoperations and reconstruction of the pulmonary arteries at the time of de-banding. The aim of this work was to study a simple and reproducible surgical protocol based primarily on systemic Oxygen saturation monitoring using pulse oximerty, to achieve effective pulmonary artery banding in children with congenital heart diseases presenting to the cardiothoracic surgery department of Alexandria university hospitals. |