Mets Gilles, Panzer Joseph, De Wolf Daniël, Bové Thierry
Department of Pediatrics, University Hospital of Ghent, Ghent, Belgium.
Department of Pediatric Cardiology, University Hospital of Ghent, Ghent, Belgium.
Pediatr Cardiol. 2017 Jun;38(5):902-908. doi: 10.1007/s00246-017-1610-0. Epub 2017 Mar 29.
Dilated cardiomyopathy in children still has a poor prognosis with high rates of mortality and cardiac transplantation (resp. around 20 and 25%). Awaiting transplantation or possible recovery, these pediatric patients are mechanically supported with extracorporeal membrane oxygenation or a paracorporeal ventricular assist device, both resulting in higher survival rates but also entailing considerable risks of infection, thrombosis, or bleeding. A new indication for an old technique, i.e., pulmonary artery banding, presents itself as an interesting alternative to mechanical circulatory support in selected infants and small children with dilated LV cardiomyopathy and preserved RV function. Here we present a brief review of literature and report on two patients in whom PAB has been successfully implemented as either bridge-to-recovery or bridge-to-transplant.
儿童扩张型心肌病的预后仍然很差，死亡率和心脏移植率很高（分别约为20%和25%）。在等待移植或可能康复期间，这些儿科患者通过体外膜肺氧合或体外心室辅助装置进行机械支持，这两种方法都能提高生存率，但也带来了感染、血栓形成或出血的巨大风险。一种旧技术——肺动脉环扎术的新适应证，成为了在选定的患有扩张型左心室心肌病且右心室功能保留的婴儿和年幼儿童中替代机械循环支持的有趣选择。在此，我们简要回顾文献，并报告两例成功实施肺动脉环扎术作为过渡到康复或过渡到移植的患者。
