Yoshimoto Akihiro, Miyamoto Takashi, Ozaki Shinichi, Kobayashi Tohru, Kobayashi Tomio
Department of Cardiovascular Surgery and Cardiology, Gunma Children's Medical Center, 779, Shimohakoda, Hokkitsu, Shibukawa, Gunma 377-8577, Japan.
Gen Thorac Cardiovasc Surg. 2013 Jun;61(6):340-4. doi: 10.1007/s11748-013-0221-9. Epub 2013 Feb 19.
We perform bilateral pulmonary artery banding (BPAB) combined with postoperative percutaneous pulmonary artery balloon dilatation (PABD) as stage I palliation for severe congenital heart diseases. The objective of this study was to evaluate the efficacy of our management strategy for the treatment of severe congenital heart diseases.
From October 2007 to March 2010, 9 consecutive patients underwent BPAB. Subsequently, all patients had a second-stage operation; we performed biventricular repair for 3 cases and univentricular repair for 6 cases. Clinical data were obtained by retrospectively reviewing medical records.
There was no early mortality (30 days). After the neonatal period, we controlled the pulmonary blood flow to be slightly elevated by PABD. Therefore, the Qp/Qs level was around 1.0, which might contribute to achieving good pulmonary artery growth and avoid intraoperative pulmonary arterioplasty. Except for one patient, intraoperative pulmonary arterioplasty in the second-stage operation was not necessary. Regarding Norwood procedure, an 8 mm RV-PA (right ventricle-pulmonary artery) conduit was available for respective patients.
Although further studies are warranted, our strategy might prove to be a valid clinical option for the treatment of severe congenital heart diseases.
我们采用双侧肺动脉环缩术（BPAB）联合术后经皮肺动脉球囊扩张术（PABD）作为重症先天性心脏病的一期姑息治疗方法。本研究的目的是评估我们的治疗策略对重症先天性心脏病的治疗效果。
2007年10月至2010年3月，连续9例患者接受了BPAB。随后，所有患者均接受了二期手术；我们对3例患者进行了双心室修复，对6例患者进行了单心室修复。通过回顾病历获取临床数据。
无早期（30天）死亡病例。在新生儿期后，我们通过PABD将肺血流量控制在略高于正常水平。因此，Qp/Qs水平约为1.0，这可能有助于实现肺动脉的良好生长并避免术中肺动脉成形术。除1例患者外，二期手术中无需进行术中肺动脉成形术。对于诺伍德手术，分别为每位患者准备了一根8毫米的右心室-肺动脉（RV-PA）导管。
尽管有必要进行进一步研究，但我们的策略可能被证明是治疗重症先天性心脏病的一种有效的临床选择。
