Use of transesophageal echocardiography guidance for pulmonary artery banding in a cat with ventricular septal defect.

TEE guidance improves intraoperative assessment of pulmonary artery banding adequacy in cats.

Pulmonary artery banding (PAB) is a palliative surgical procedure for managing hemodynamically significant ventricular septal defects (VSDs) by increasing right ventricular afterload and reducing left-to-right shunting. This case report documents the successful application of transesophageal echocardiography (TEE) as an intraoperative guidance tool for PAB in a feline patient. Traditional PAB guidelines recommend reducing pulmonary artery diameter to approximately one-third of its original size. However, modern approaches employ real-time intraoperative monitoring techniques including intracardiac pressure measurements, oxygen saturation assessment, and echocardiographic evaluation. In this case, TEE proved particularly valuable by enabling direct visualization and measurement of shunting flow velocities across the VSD, allowing the surgical team to titrate the degree of banding precisely and optimize hemodynamic parameters intraoperatively. This approach represents an advancement over diameter-based banding criteria, providing objective physiologic feedback to guide surgical decision-making and potentially improve procedural outcomes in feline cardiac patients.

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