Functional regeneration of dilated cardiomyopathy by transcatheter bilateral pulmonary artery banding: first-in-human case series

European Heart Journal - Case Reports, vol. 7, pp. ytad052

Abstract

Abstract Background Dilated cardiomyopathy (DCM) is a leading cause of heart transplantation (HTx) in children. Surgical pulmonary artery banding (PAB) is used worldwide to achieve functional heart regeneration and remodelling. Case summary We report for the first-time successful bilateral transcatheter implantation of bilateral pulmonary artery flow restrictors in a case series of three infants with severe DCM based on left-ventricular non-compaction morphology associated with Barth syndrome in one and a non-classified syndrome in another. Functional cardiac regeneration was observed in two patients after almost 6 months of endoluminal banding, and in the neonate with Barth syndrome already after 6 weeks. Accompanied by an improvement in functional class (Class IV to Class I), the left ventricular end-diastolic dimensions z-score normalized, as did the elevated serum brain natriuretic peptide levels. A listing for HTx could be avoided. Discussion Percutaneous bilateral endoluminal PAB is a novel minimally invasive approach that enables functional cardiac regeneration in infants with severe DCM and preserved right ventricular function. Interruption of the ventriculo-ventricular interaction, the key mechanism for recovery, is avoided. Intensive care for these critically ill patients is reduced to a minimum. However, investing in ‘heart regeneration to avoid transplantation’ remains a challenge.

Authors 5

1. Dietmar Schranz corresponding

   Goethe University Frankfurt

   Affiliation as printed

   Pediatric Cardiology, Children’s Hospital, Johann Wolfgang Goethe University , Theodor-Stern-Kai 7, Frankfurt D-60596 , Germany

2. Ulrich Krause

   Universitätsmedizin Göttingen · University of Göttingen

   Affiliation as printed

   Department of Pediatric Cardiology, Georg-August-University Medical Center , Göttingen , Germany

3. Gunter Kerst Aachen Department of Pediatric Cardiology

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Pediatric Cardiology, University Hospital RWTH Aachen , Aachen , Germany

4. Anoosh Esmaeili

   Goethe University Frankfurt

   Affiliation as printed

   Pediatric Cardiology, Children’s Hospital, Johann Wolfgang Goethe University , Theodor-Stern-Kai 7, Frankfurt D-60596 , Germany

5. Thomas Paul

   Universitätsmedizin Göttingen · University of Göttingen

   Affiliation as printed

   Department of Pediatric Cardiology, Georg-August-University Medical Center , Göttingen , Germany