Parry R L, Gordon S, Sherman N J
Division of Pediatric Surgery, Children's Hospital Los Angeles, CA, USA.
J Pediatr Surg. 1997 Jan;32(1):48-9. doi: 10.1016/s0022-3468(97)90091-9.
Pulmonary artery banding is used in infants to temporarily control excessive pulmonary blood flow. There are reports of band migration including intact bands eroding through the pulmonary artery. The patient presented here had bronchiectasis and eventual destruction of his right middle and lower lobes 5 years after pulmonary artery banding and subsequent definitive cardiac corrective surgery. After undergoing a right middle and lower lobectomy, recurring postoperative respiratory distress prompted repeat bronchoscopy where the original pulmonary artery band was identified and removed. It is hypothesized that this band migrated through the pulmonary artery and into the tracheobronchial tree where it led to obstruction and subsequent destruction of the right middle and lower lobes. Awareness of this potential complication is important for pediatric surgeons who so often care for patients with a past history of cardiac surgery.
肺动脉束带术用于婴儿以暂时控制肺血流量过多。有关于束带移位的报道，包括完整的束带侵蚀肺动脉。本文介绍的患者在接受肺动脉束带术及随后的确定性心脏矫正手术后5年，出现支气管扩张并最终右中、下叶毁损。在接受右中、下叶切除术后，术后反复出现的呼吸窘迫促使再次进行支气管镜检查，在此过程中发现并移除了原来的肺动脉束带。据推测，该束带穿过肺动脉进入气管支气管树，导致阻塞并随后造成右中、下叶毁损。对于经常照料有心脏手术既往史患者的小儿外科医生而言，认识到这种潜在并发症很重要。
