Wang Zhangwei
Department of Cardiovascular Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Fuwai Hospital, No.167 Beilishi Road, Xicheng District, Beijing, China.
Pediatr Cardiol. 2024 Oct 19. doi: 10.1007/s00246-024-03685-5.
Lack of appropriate durable Ventricular Assist Devices (VADs) that can be managed at home for very young children, and long wait times for transplant have led to search for alternate easily reproducible therapies. In the past decade or more, pulmonary artery banding (PAB), as a new indication of an old technology, has been gradually carried out worldwide as an alternative to mechanical circulatory support in children with end-stage left ventricular dilated cardiomyopathy (DCM) complicated with heart failure(HF), and has achieved encouraging early and mid-term outcomes. Technically, PAB is simple, safe, and effective. This is a promising therapeutic strategy, especially in developing countries where heart transplantation is difficult to implement. As a transition before transplantation, and even a potential treatment, PAB brings more options and hope for children with heart failure who are waiting for transplantation and are refractory to drug therapy. This article reviews the past and current situation, the mechanism, the surgical timing, and application prospect of PAB in the treatment of DCM complicated with heart failure.
缺乏适合在家中管理的非常年幼儿童的耐用心室辅助装置（VAD），以及移植等待时间长，导致人们寻求易于复制的替代疗法。在过去十年或更长时间里，作为一项旧技术的新应用，肺动脉环扎术（PAB）已在全球范围内逐渐开展，作为终末期左心室扩张型心肌病（DCM）合并心力衰竭（HF）儿童机械循环支持的替代方法，并取得了令人鼓舞的早期和中期效果。从技术上讲，PAB简单、安全且有效。这是一种很有前景的治疗策略，尤其是在难以实施心脏移植的发展中国家。作为移植前的过渡，甚至是一种潜在的治疗方法，PAB为等待移植且对药物治疗无效的心力衰竭儿童带来了更多选择和希望。本文综述了PAB治疗DCM合并心力衰竭的过去和现状、机制、手术时机及应用前景。
