El-Said Howaida, Hamzeh Rabih, Lamberti John, Moore John
Department of Pediatric Cardiology, Rady Children's Hospital, University of California, San Diego, San Diego, CA, USA.
Pediatr Cardiol. 2011 Jan;32(1):8-16. doi: 10.1007/s00246-010-9796-4. Epub 2010 Oct 31.
The study aimed to assess the feasibility and safety of increasing pulmonary artery band (PAB) diameter by catheter-based PAB balloon dilation (PABBD). Eight dilations were performed between October 2006 and December 2008. Hemoclips were used to fix PABs surgically in a procedure designed to permit progressive clip dislodgment in a controlled manner. The PABBD resulted in gradual band loosening until the desired physiologic state was achieved. At time of PABBD, the patients had a mean age of 6 months (range 3-14 months) and a mean weight of 5 kg (range 2.6-7.3 kg). The median time from PAB placement until PABBD was 4.5 months (range 1-9 months). The single-balloon technique was used in seven cases (serial dilations in 5 cases) and the double-balloon technique in one case. The PABBDs were successful for all the patients, who experienced a mean saturation increase of 75-89% (P = 0.01) (mean increase of 20%), a mean PAB gradient decrease from 69 to 36 mmHg (P = 0.002) (mean decrease of 49%), and a mean band site diameter increase from 4.1 to 6.1 mm (P = 0.01) (mean increase of 45%). The only complication was transient pulmonary edema in one patient. The PABBD procedure is a feasible and safe method for increasing pulmonary blood flow in a staged manner and may eliminate the need for surgical band removal in some cases.
该研究旨在评估通过基于导管的肺动脉环缩（PAB）球囊扩张术（PABBD）增加肺动脉环缩直径的可行性和安全性。在2006年10月至2008年12月期间进行了8次扩张。在一种旨在允许以可控方式逐步松开夹子的手术过程中，使用血管夹手术固定PAB。PABBD导致环缩逐渐松开，直至达到所需的生理状态。在进行PABBD时，患者的平均年龄为6个月（范围3 - 14个月），平均体重为5千克（范围2.6 - 7.3千克）。从放置PAB到进行PABBD的中位时间为4.5个月（范围1 - 9个月）。7例采用单球囊技术（5例为连续扩张），1例采用双球囊技术。所有患者的PABBD均成功，患者的平均饱和度增加了75 - 89%（P = 0.01）（平均增加20%），平均PAB梯度从69降至36 mmHg（P = 0.002）（平均降低49%），环缩部位的平均直径从4.1增加到6.1 mm（P = 0.01）（平均增加45%）。唯一的并发症是1例患者出现短暂性肺水肿。PABBD手术是一种可行且安全的方法，可分阶段增加肺血流量，在某些情况下可能无需进行手术拆除环缩。
