Koh Y, Imai Y, Kurosawa H, Soejima K, Fukuchi S, Sawatari K, Kawada M, Matsuo K, Shinoka T, Yamagishi M
Department of Pediatric Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Feb;38(2):194-200.
Thirteen patients with double-inlet left ventricle who had undergone pulmonary artery banding (PAB) were reviewed. At the time of PAB, the age ranged from 2 months to 3 years. Pulmonary-systemic arterial pressure ratio and pulmonary arterial mean pressure were reduced from 0.95 +/- 0.12 to 0.4 +/- 0.18, and from 57.3 +/- 11.6 mmHg to 29.9 +/- 12.7 mmHg after PAB. Pulmonary resistance showed no statistically significant change after PAB. (from 7.6 +/- 5.2 unit to 4.8 +/- 3.9 unit) Ventricular end-diastolic volume decreased from 379.9% +/- 140.0% to 275.7% +/- 118.0% after PAB. The smallest one was 170% who successfully underwent septation procedure. Ejection fraction significantly decreased from 64.5 +/- 6.1% to 56.3 +/- 7.9%. (p less than 0.005) Ventricular end-diastolic pressure showed no significant change after PAB. (from 9.2 +/- 2.8 mmHg to 9.9 +/- 2.0 mmHg) After PAB subaortic stenosis occurred in three cases and pressure gradient were 10, 20, and 85 mmHg, respectively. Seven cases, including three cases with subaortic stenosis, underwent septation procedure and all survived. Before septation, ventricular end-diastolic volume calculated as % of normal left ventricular volume ranged from 173% to 570% and pulmonary resistance ranged from 1.6 unit to 11 unit. These data suggested that the patients with double-inlet left ventricle had efficient ventricular volume and cardiac function for septation even after PAB.
对13例接受肺动脉环扎术(PAB)的双入口左心室患者进行了回顾性研究。在进行PAB时,年龄范围为2个月至3岁。PAB后,肺循环与体循环动脉压比值和肺动脉平均压分别从0.95±0.12降至0.4±0.18,从57.3±11.6 mmHg降至29.9±12.7 mmHg。PAB后肺血管阻力无统计学显著变化(从7.6±5.2单位降至4.8±3.9单位)。PAB后心室舒张末期容积从379.9%±140.0%降至275.7%±118.0%。最小的为170%,其成功接受了分隔手术。射血分数从64.5±6.1%显著降至56.3±7.9%。(p<0.005)PAB后心室舒张末期压力无显著变化(从9.2±2.8 mmHg升至9.9±2.0 mmHg)。PAB后3例发生主动脉瓣下狭窄,压力阶差分别为10、20和85 mmHg。7例患者,包括3例主动脉瓣下狭窄患者,接受了分隔手术,全部存活。在分隔前,以正常左心室容积百分比计算的心室舒张末期容积范围为173%至570%,肺血管阻力范围为1.6单位至11单位。这些数据表明,即使在PAB后,双入口左心室患者仍具有进行分隔手术的有效心室容积和心功能。