Talwar Sachin, Kamat Neeraj Aravind, Choudhary Shiv Kumar, Ramakrishnan Sivasubramanian, Saxena Anita, Juneja Rajnish, Kothari Shyam Sunder, Airan Balram
Department of Cardiothoracic & Vascular Surgery, All India Institute of Medical Sciences, New Delhi 110029, India.
Department of Cardiothoracic & Vascular Surgery, All India Institute of Medical Sciences, New Delhi 110029, India.
Indian Heart J. 2016 Jan-Feb;68(1):72-6. doi: 10.1016/j.ihj.2015.06.036. Epub 2016 Jan 14.
The adjustable pulmonary artery band (APAB) has been demonstrated by us earlier to be superior to the conventional pulmonary artery banding (CPAB), in terms of reduced early morbidity and mortality. In this study, we assessed the adequacy of the band and its complications over the mid-term.
Between 2002 and 2012, 73 patients underwent adjustable PAB, and their operative and follow-up data were collected and analyzed.
There was one early death following the APAB. Follow-up data were available for 57 patients of which 44 patients (61.7%) underwent definitive repair, 10 were awaiting definitive repair, and 3 patients were kept on medical follow-up because of inadequate fall in pulmonary artery (PA) pressures. 14 patients (19%) were lost to follow-up. Major PA distortion or stenosis was absent in the majority. 1 patient had pseudoaneurysm of the main pulmonary artery (MPA) with sternal sinus infection and required surgical reconstruction. 1 patient had infective endocarditis of the pulmonary valve managed medically. Band migration was not encountered. There were two deaths after definitive repair and one after APAB.
Patients undergoing APAB fulfilled the desired objectives of the pulmonary artery banding (PAB) with minimum PA complications in the mid-term. This added to the early postoperative benefits, makes the APAB an attractive alternative to the CPAB.
我们先前已证明,可调节肺动脉环扎术(APAB)在降低早期发病率和死亡率方面优于传统肺动脉环扎术(CPAB)。在本研究中,我们评估了中期时环扎带的适用性及其并发症。
2002年至2012年间,73例患者接受了可调节肺动脉环扎术,并收集和分析了他们的手术及随访数据。
APAB术后有1例早期死亡。57例患者有随访数据,其中44例(61.7%)接受了根治性修复,10例等待根治性修复,3例因肺动脉(PA)压力下降不足而接受医学随访。14例患者(19%)失访。大多数患者未出现严重的PA扭曲或狭窄。1例患者主肺动脉(MPA)假性动脉瘤合并胸骨窦感染,需要手术重建。1例患者肺动脉瓣感染性心内膜炎接受药物治疗。未遇到环扎带移位情况。根治性修复后有2例死亡,APAB术后有1例死亡。
接受APAB的患者在中期实现了肺动脉环扎术(PAB)的预期目标,PA并发症最少。这增加了术后早期的益处,使APAB成为CPAB的一个有吸引力的替代方案。