Pulmonary artery plication: a new surgical procedure for small infants with type I truncus arteriosus.

A new technique is reported for constriction of the pulmonary artery ostium as a palliative procedure in infants with type I truncus arteriosus. Pulmonary artery plication was performed without cardiopulmonary bypass, and this allowed intraoperative evaluation of the procedure. The lungs were protected from developing pulmonary vascular obstructive disease, and congestive heart failure resolved. The pulmonary arteries and the ostium grew with the child so that corrective surgery could be delayed until 4 1/2 years of age, when a large (20 mm) valved extracardiac conduit could be placed. We believe this is a useful palliative operation, particularly for small, sick infants, and it deserves further evaluation.