Background
The major difficulty of pulmonary artery banding (PAB) is optimal intraoperative adjustment.
In this study, a target intraoperative shunt ratio (Qp/Qs) was utilised to evaluate a fixed Trusler's formula for the degree of PAB of infants
destined for either univentricular or biventricular surgical route.
Methods
Ten consecutive infants (median age, 1.62 months) undergoing PAB through median sternotomy
were studied. A fixed Trusler's formula (20 mm + 1 mm/kg body weight) was used to set the initial band size, and subsequent intraoperative
adjustment was based on target Qp/Qs (using oxymetric data). Suitable target Qp/Qs was set ≤0.5 for the biventricular repair group (six patients) and ≤0.3 for the univentricular
palliation group (four patients).
Results
In the biventricular group, the target mean Qp/Qs of 0.4 was achieved according to the fixed formula. However the band size was narrower
in the univentricular group by 2.25 mm to achieve the target mean Qp/Qs of 0.27 instead of a higher level (2.2) with the fixed formula.
Conclusion
Using the intraoperative Qp/Qs calculation, the circumference of the band was in agreement with the fixed formula
of Trusler for the biventricular repair group, however a narrower band size is recommended
for the univentricualr palliation group.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Heart, Lung and CirculationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- A method of banding the pulmonary artery for large isolated ventricular septal defect with and without transposition of the great arteries.Ann Thorac Surg. 1972; 13: 351-355
- Pulmonary artery banding.J Thorac Cardiovasc Surg. 1984; 88: 645-653
- Tricuspid atresia and management of single-ventricle physiology.in: Kouchoukos N.T. Blackstone E.H. Doty D.B. Hanley F.L. Karp R.B. Kirklin/Barratt-Boyes cardiac surgery. 3rd ed. Churchill Livingstone, Edinburgh, Scotland2003: 1113-1175 (Chapter 27)
- Cardiac catheterization: hemodynamic measurements.in: Garson Jr., A. Bricker J.T. Fisher D. Neish S.R. The science and practice of pediatric cardiology. 2nd ed. William and Wilkins, Baltimore, MD1998: 961-993 (Chapter 43)
- Remote control of pulmonary blood flow: initial clinical experience.J Thorac Cardiovasc Surg. 2003; 126: 1775-1780
- Chronic and adjustable pulmonary artery banding.J Thorac Cardiovasc Surg. 2003; 125: 231-237
- Pulmonary artery banding with a novel percutaneously, bidirectionally adjustable device.Eur J Cardiothorac Surg. 1997; 12: 931-933
- Pseudoaneurysm of the pulmonary trunk after placement of an adjustable pulmonary artery banding device (FloWatch-PAB) in a patient with muscular ventricular septal defect.J Thorac Cardiovasc Surg. 2005; 130: 894-895
- Pulmonary artery banding in infants: a physiological intraoperative method of determining the effectiveness of the procedure.Ann Thorac Surg. 1974; 17: 492-495
Article info
Publication history
Accepted:
February 20,
2009
Received in revised form:
February 20,
2009
Received:
January 4,
2009
Identification
Copyright
© 2009 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.
