Objectives
To review the results of Pulmonary Artery Banding (PAB) in Complete Atrio-Ventricular Septal Defects (cAVSD).

Methods
From 2000 to 2008 19 patients with cAVSD underwent PAB because of unsuitable intra-cardiac anatomy (unbalanced ventricles and/or associated lesions) or clinical condition (late presentation with pulmonary hypertension, infection, chronic lung disease, non-cardiac malformation).
Since 2005 FloWatch PAB was introduced in our institute.
Patients were retrospectively divided in Group A (conventional PAB): n=14 (74%), median age 67 days (range 6-635 days), median weight 3.4 Kg (range 2.1-8.6 Kg) and Group B (FloWatch PAB): n=5 (26%), median age 120 days (range 81-181 days, N.S.), median weight 4.5 Kg (range 3.2-6.1 Kg, N.S.).

Results
10/14 patients in Group A died (=71.4%) versus 0/5 in Group B (=0%, P<0.005).
Median ICU stay was 10 days (range 1-61 days) in Group A and 4.5 days (range 2-9 days) in Group B (P<0.05), while median Mechanical Ventilation duration was 9 days (range 0-61 days) in Group A and 3 days (range 1-8 days in Group B, P<0.05).
6/8 survivors (1 from Group A and 5 from group B) underwent repair after a median interval of 125 days (range 34-871 days), 2/8 are waiting for repair.

Conclusions
In patients with cAVSD complicated by intra-cardiac anatomy unsuitable for repair and/or high-risk clinical condition, PAB followed by late repair is a viable alternative surgical option.
In this group of patients the introduction of adjustable FloWatch PAB not only improved survival but made later repair feasible in better clinical conditions.