S-Space College of Medicine/School of Medicine (의과대학/대학원) Thoracic Surgery (흉부외과학전공) Journal Papers (저널논문_흉부외과학전공)
Pulmonary artery banding before the Damus-Kaye-Stansel procedure
- Chang, Yun Hee; Kim, Woong-Han; Lee, Jae Young; Kim, Soo-Jin; Lee, Cheul; Hwang, Seong Wook; Sung, Si Chan
- Issue Date
- Springer Verlag
- Pediatr Cardiol. 2006 Sep-Oct;27(5):594-9. Epub 2006 Aug 23.
- Discrete Subaortic Stenosis/complications/congenital/*surgery; Follow-Up Studies; Fontan Procedure/*methods; Heart Defects, Congenital/complications/*surgery; Heart Ventricles/*abnormalities; Humans; Infant; Infant, Newborn; Pulmonary Artery/*surgery; Retrospective Studies; Treatment Outcome; Vascular Surgical Procedures/*methods
- Subaortic stenosis (SAS) in a single ventricle leads to myocardial hypertrophy and compromises Fontan results. Moreover, controversy exists concerning the optimal surgical strategy for relieving SAS. We have applied pulmonary artery banding (PAB) before the Damus-Kaye-Stansel procedure (DKS), and here we analyze factors that influence systemic ventricular compliance. Thirteen patients underwent PAB before DKS. Median PAB duration was 5.5 months (range, 20 days to 17.7 months). Procedures administered concomitantly with DKS were Blalock-Taussig shunt (n = 6), bidirectional cavopulmonary shunt (n = 5), and Fontan operation (n = 2). All survived and were doing well after a median follow-up 2.7 years. Cardiac catheterization before DKS showed that the mean pressure gradient across the systemic ventricular outflow tract and PAB were 20.6 +/- 10.1 and 67.4 +/- 10.2 mmHg, respectively. After DKS, systemic ventricular end diastolic pressure (SVEDP) was significantly correlated with PAB duration (r = 0.65, p = 0.022), but not with PAB or systemic ventricle outflow tract pressure gradients. After DKS, SVEDP decreased or fell to within the range in patients with PAB duration less than 7 months (p < 0.05). Seven patients had a successful Fontan operation, and 6 without risk factors are waiting operation. SVEDP was found to be correlated with PAB duration, and our findings indicate that short-term PAB can be considered a safe option in patients with a single ventricle and SAS.
- 0172-0643 (Print)
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