In the surgical management of excessive pulmonary blood flow without obstructing the aorta, what procedure is indicated?

The surgical management of excessive pulmonary blood flow, particularly when the aorta is not obstructed, often requires a procedure that effectively reduces pulmonary blood flow to prevent pulmonary over-circulation and related complications.

The PA banding procedure specifically aims to restrict blood flow to the pulmonary arteries. In cases of conditions leading to excessive pulmonary blood flow, such as certain types of congenital heart defects, PA banding is utilized to create controlled resistance, reducing the volume of blood that reaches the lungs while allowing for adequate systemic circulation. This can alleviate symptoms and complications associated with excessive pulmonary blood flow.

Other procedures listed have different indications. The Fontan procedure is typically indicated for patients with single ventricle physiology and is aimed at directing venous return to the systemic circulation without passing through the heart. The Norwood Stage I procedure is a first-stage operation for hypoplastic left heart syndrome, intended to establish systemic blood flow and is not specifically aimed at addressing pulmonary blood flow issues. The Glenn procedure involves connecting the superior vena cava directly to the pulmonary artery and is generally performed after the initial stages of management for single ventricle anatomy, rather than for the isolated issue of excessive pulmonary blood flow.

Thus, PA banding is the most appropriate choice for addressing excessive pulmonary blood