Banding a Systemic-to-Pulmonary Shunt to Balance Pulmonary Blood Flow

Neonates with a systemic-to-pulmonary shunt often experience hemodynamic instability due to pulmonary overcirculation and resultant systemic malperfusion. Herein, we describe a technique of shunt banding, a reproducible method to mechanically limit the blood flow through the systemic-to-pulmonary shunt. A mathematical rationale, the surgical techniques, postoperative management, and our clinical experiences are described.