Albus R A, Trusler G A, Izukawa T, Williams W G
J Thorac Cardiovasc Surg. 1984 Nov;88(5 Pt 1):645-53.
Two hundred nine children with congenital heart defects characterized by excessive pulmonary blood flow underwent pulmonary artery banding at The Hospital for Sick Children from January, 1972, through December, 1982. The indications for banding, rather than complete repair, varied with the type of cardiac defect as well as with the year of presentation to our hospital. A simplified method of estimating required band circumference has been developed for infants with ventricular septal defect, with or without major intracardiac mixing disorders. Infants with simple defects without intracardiac bidirectional mixing disorders receive a band at a circumference of 20 mm + 1 mm for each kilogram of body weight, whereas infants with bidirectional mixing disorders receive a band at a circumference of 24 mm + 1 mm for each kilogram of body weight. The overall operative mortality varies with the underlying cardiac defect and with associated medical conditions but is relatively low in the less-complicated cases. The use of a formula to predict a starting band circumference, with loosening only as required by cyanosis or bradycardia, allows predictable control of congestive symptoms and pulmonary hypertension in the majority of infants. The cumbersome measurement of pulmonary artery pressure and the unpredictable changes in pressure during anesthesia are avoided. Pulmonary artery banding remains an effective means of achieving satisfactory palliation in infants with congenital heart disease and excessive pulmonary blood flow.
1972年1月至1982年12月期间，209名患有以肺血流量过多为特征的先天性心脏病儿童在病童医院接受了肺动脉环扎术。环扎而非完全修复的适应症因心脏缺陷类型以及来我院就诊年份而异。已为患有或不患有严重心内混合性疾病的室间隔缺损婴儿开发了一种简化的估计所需环扎周长的方法。无心脏内双向混合性疾病的单纯缺陷婴儿，每公斤体重接受周长为20毫米 + 1毫米的环扎带，而有双向混合性疾病的婴儿，每公斤体重接受周长为24毫米 + 1毫米的环扎带。总体手术死亡率因潜在心脏缺陷和相关医疗状况而异，但在不太复杂的病例中相对较低。使用公式预测起始环扎周长，仅在出现紫绀或心动过缓时才进行松解，可在大多数婴儿中实现对充血症状和肺动脉高压的可预测控制。避免了繁琐的肺动脉压力测量以及麻醉期间压力的不可预测变化。肺动脉环扎术仍然是为患有先天性心脏病和肺血流量过多的婴儿实现满意姑息治疗的有效手段。
