10:30 〜 12:00
[II-S11-03] 二心室修復を目的として両側肺動脈絞扼術を施行した症例の検討
【Objective】Bilateral pulmonary artery banding (BPAB) was introduced for avoiding preoperative risks of the congenital heart defects depending on patent ductus arteriosus. We selected BPAB if patient had a shock, severe extra cardiac anomalies, heterotaxy or low body weight (<2.5kg). The purpose of this study was to investigate the outcome of BPAB for biventricular repair (BVR).
【Patients and Methods】10 patients underwent BPAB between 2003 and 2015. There were IAA/CoA in 7 and TAC in 3. BPAB was performed by lasso technique.
【Results】Median age and body weight at the surgery were 7.2days (1-27 days), 2.6kg (1.6-3.2 kg), respectively. The reasons of BPAB were shock in 6, low body weight in 5, LVOT in 2, ventricular size in 1. The circumference of BPAB was 12.5mm (9.0-13.5 mm). The duration to 2nd surgery was 62 days (28-313 days). Re-PAB (adjustment) was required in 2. Completion of BVR was in 7 (Yasui in 3, Rastelli in 2, ICR in 2), Waiting of BVR in 2, HD in 1 (preoperative brain hemorrhage due to shock). One patient died at 5 years after Rastelli operation. 2 patients with low body weight (1.6kg, 1.8kg) required PTA before 2nd operation because of decreased pulmonary blood flow. 6 patients required PA angioplasty or PTA at BVR or later.
【Summary】The reason of BPAB was simply avoiding risk rather than morphological reason. BVR for low body weight patients could be performed after several PTAs. Although PA angioplasty was required at BVR or conduit replacement, there was no re-operation for branch PS because PTA was effective.
【Patients and Methods】10 patients underwent BPAB between 2003 and 2015. There were IAA/CoA in 7 and TAC in 3. BPAB was performed by lasso technique.
【Results】Median age and body weight at the surgery were 7.2days (1-27 days), 2.6kg (1.6-3.2 kg), respectively. The reasons of BPAB were shock in 6, low body weight in 5, LVOT in 2, ventricular size in 1. The circumference of BPAB was 12.5mm (9.0-13.5 mm). The duration to 2nd surgery was 62 days (28-313 days). Re-PAB (adjustment) was required in 2. Completion of BVR was in 7 (Yasui in 3, Rastelli in 2, ICR in 2), Waiting of BVR in 2, HD in 1 (preoperative brain hemorrhage due to shock). One patient died at 5 years after Rastelli operation. 2 patients with low body weight (1.6kg, 1.8kg) required PTA before 2nd operation because of decreased pulmonary blood flow. 6 patients required PA angioplasty or PTA at BVR or later.
【Summary】The reason of BPAB was simply avoiding risk rather than morphological reason. BVR for low body weight patients could be performed after several PTAs. Although PA angioplasty was required at BVR or conduit replacement, there was no re-operation for branch PS because PTA was effective.