Changizi Ali, Yaghoubi Alireza, Azarasa Mitra, Ghaffari Shamsi, Montazerghaem Hossein
Bou ali Sina Hospital, Qazvin University of Medical sciences, Qazvin, Iran.
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
J Cardiovasc Thorac Res. 2014;6(4):253-5. doi: 10.15171/jcvtr.2014.021. Epub 2014 Dec 30.
Pulmonary artery (PA) banding is a procedure associated with high morbidity and mortality rates. It however can effectively palliate several forms of congenital heart lesions with increased pulmonary flow. Occasionally, to obtain an optimal degree of banding following operation, readjustment of the band is inevitable. We describe the technique of adjustable PA banding to prevent this problem.
From June 2007 to 2008, 21 patients with congenital cardiac abnormalities including Single ventricle (1), transposition of great arteries (TGA) (4) and ventricular septal defect (VSD) (16) were operated via percutaneously adjustable PA banding in Madani Hospital (Tabriz, Iran).
The mean age and the mean weight of the patients were 12±.8 months and 61±.7 kg respectively. Seventeen (81%) patients survived the operation. Cause of death was heart failure in 2 (9.5%) patients, and arrhythmia in 2 (9.5%) patients. Later, patients were followed up for 6 months. Satisfactory band gradient was achieved between 48 and 240 hours. Mean PA gradient before and 1 and 6 months after adjusting was (55.3±7.1 mmHg), (54.7±5.1 mmHg), and (53.2±5.4 mmHg) respectively. In the follow up period, there were 2 deaths, one caused by aspiration pneumonia and one caused by poor mixing. Postoperative complications were observed in 28.5% of the cases including cardiac (10%), pulmonary (pneumothorax, pneumonia) (10%) and infectious complications (9%).
The technique of percutaneously adjustable PA banding is simple and inexpensive and allows easy band adjustments without the need for multiple reoperations. Moreover, our assessment reveals that created gradient is constant and did not decrease with time.
肺动脉（PA）环扎术是一种与高发病率和死亡率相关的手术。然而，它可以有效地缓解几种肺血流量增加的先天性心脏病变。偶尔，为了在术后获得最佳的环扎程度，不可避免地需要对环扎带进行重新调整。我们描述了可调节肺动脉环扎术的技术以预防这个问题。
2007年6月至2008年，21例先天性心脏异常患者，包括单心室（1例）、大动脉转位（TGA）（4例）和室间隔缺损（VSD）（16例），在马丹尼医院（伊朗大不里士）通过经皮可调节肺动脉环扎术进行手术。
患者的平均年龄和平均体重分别为12±0.8个月和61±0.7千克。17例（81%）患者术后存活。2例（9.5%）患者死于心力衰竭，2例（9.5%）患者死于心律失常。随后，对患者进行了6个月的随访。在48至240小时之间实现了满意的环扎带梯度。调整前、调整后1个月和6个月时的平均肺动脉梯度分别为（55.3±7.1mmHg）、（54.7±5.1mmHg）和（53.2±5.4mmHg）。在随访期间，有2例死亡，1例死于吸入性肺炎，1例死于混合不良。28.5%的病例观察到术后并发症，包括心脏并发症（10%）、肺部并发症（气胸、肺炎）（10%）和感染性并发症（9%）。
经皮可调节肺动脉环扎术技术简单且成本低廉，无需多次再次手术即可轻松调整环扎带。此外，我们的评估显示所产生的梯度是恒定的，并且不会随时间降低。
