Abstract： Objective To evaluate clinical outcomes of pulmonary artery banding for morphologic left ventricular training in corrected transposition of the great arteries.?Methods?A total of 89 patients with corrected transposition of the great arteries underwent surgical repair in Shanghai Children’s Medical Center from January 2007 to December 2011 year. Among them, 11 patients underwent pulmonary artery banding, whose clinical records were retrospectively analyzed. Except that one patient was 12 years, all other patients were 3 to 42 （16.40±11.67） months old and had a body weight of 6 to 32 （11.70±7.20）kg. All the patients were diagnosed by echocardiogram and angiocardiogram.?Results?There was no postoperative death after pulmonary artery banding in 11 patients. The pulmonary arterial pressure/systemic blood pressure ratio （Pp/Ps） was 0.3 to 0.6 （0.44±0.09） preoperatively and 0.6 to 0.8 （0.70±0.04） postoperatively with statistical difference （P＜0.01）. Tricuspid regurgitation was mild in 2 （18.2%） patients, moderate in 5 （45.4%）, severe in 4 （36.4%）preoperatively，and none in 2（18.2%）patients, mild in 7 （63.6%），and mild to moderate in 2 （18.2%）postoperatively. Five patients underwent staged double-switch operation after pulmonary artery banding at 15.20±8.31 months, and 1 patient died. The other 6 patients were followed up for 18.83±3.43 months, and echocardiogram showed tricuspid regurgitation as trivial in 2 （33.3%）, mild in 3 （50.0%）, and moderate in 1 （16.7%）patient.?Conclusions?In patients with corrected transposition of the great arteries, pulmonary artery banding is helpful to reduce tricuspid regurgitation, and morphologic left ventricle can be trained for staged double-switch operation with good clinical outcomes. It is important to follow up these patients regularly to evaluate their morphologic left ventricular function and tricuspid regurgitation after pulmonary artery banding.
Citation：
XU Zhiwei,ZHANG Haibo,ZHENG Jinghao,YAN Qing,DU Xinwei .. Pulmonary Artery Banding for Morphologic Left Ventricular Training in Corrected Transposition of the Great Arteries. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(6): 581-584. doi:
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Copyright © the editorial department of Chinese Journal of Clinical Thoracic and Cardiovascular Surgery of West China Medical Publisher. All rights reserved
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Hraska V， Duncan BW， Mayer JE Jr， et al. Long-term outcome of surgically treated patients with corrected transposition of the great arteries. J Thorac Cardiovasc Surg， 2005， 129 （1）：182-191.
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| 2. |
Yacoub MH， Radley-Smith R， Maclaurin R. Two-stage operation for anatomical correction of transposition of the great arteries with intact interventricular septum. Lancet， 1977， 1 （8025）：1275-1278.
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| 3. |
Jonas RA， Giglia TM， Sanders SP， et al. Rapid， two-stage arterial switch for transposition of the great arteries and intact ventricular septum beyond the neonatal period. Circulation， 1989， 80 （3 Pt 1）：I203-I208.
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| 4. |
Lacour-Gayet F， Piot D， Zoghbi J， et al. Surgical management and indication of left ventricular retraining in arterial Switch for transposition of the great arteries with intact ventricular septum. Eur J Cardiothorac Surg， 2001， 20 （4）：824-829.
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| 5. |
Quinn DW， Mcguirk SP， Metha C， et al. The morphologic left ventricle that requires training by means of pulmonary artery banding before the double-switch procedure for congenitally corrected transposition of the great arteries is at risk of late dysfunction. J Thorac Cardiovasc Surg， 2008， 135 （5）：1137-1144.
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| 6. |
Le Bret E， Lupoglazoff JM， Borenstein N， et al. Cardiac “fitness” training：an experimental comparative study of three methods of pulmonary artery banding for ventricular training.Ann Thorac Surg， 2005， 79 （2）：198-203.
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Jahangiri M， Redington AN， Elliott MJ， et al. A case for anatomic correction in atrioventricular discordance? Effects of surgery on tricuspid valve function. J Thorac Cardiovasc Surg， 2001， 121 （6）：1040-1045.
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Di Donato RM， Fujii AM， Jonas R， et al. Age-dependent ventricular response to pressure overload. Considerations for the arterial switch operation. J Thorac Cardiovasc Surg， 1992， 104 （3）：713-722.
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Auckland LM， Lambert SJ， Cummins P. Cardiac myosin light and heavy chain isotypes in tetralogy of Fallot. Cardiovasc Res， 1986， 20 （11）：828-836.
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Bove EL. Congenitally corrected transposition of the great arteries：surgical options for biventricular repair. Progress in Pediatric Cardiology， 1999， 10 （1）：45-49.
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Devaney EJ， Charpie JR， Ohye RG， et al. Combined arterial Switch and Senning operation for congenitally corrected transposition of the great arteries：patient selection and intermediate results. J Thorac Cardiovasc Surg， 2003， 125 （3）：500-507.
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| 12. |
Winlaw DS， Mcguirk SP， Balmer C， et al. Intention-to-treat analysis of pulmonary artery banding in conditions with a morphological right ventricle in the systemic circulation with a view to anatomic biventricular repair. Circulation， 2005， 111 （4）：405-411.
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徐志伟， 苏肇伉， 丁文祥. 快速二期动脉转位术纠治新生儿完全性大动脉转位. 中国胸心血管外科临床杂志， 2004， 11 （1）：12-15.
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徐志伟， 沈佳， 刘锦纷， 等. 快速二期大动脉转位术的左心室功能判断. 中华外科杂志， 2011， 49 （2）：158-161.
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徐志伟， 沈佳. 快速二期大动脉转位术早期死亡危险因素. 中华胸心血管外科杂志， 2011， 27 （2）：87-89.
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| 16. |
Mühlfeld C， Coulibaly M， Dörge H， et al. Ultrastructure of right ventricular myocardium subjected to acute pressure load. J Thorac Cardiovasc Surg， 2004， 52 （6）：328-333.
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| 17. |
Metton O， Gaudin R， Ou P， et al. Early prophylactic pulmonary artery banding in isolated congenitally corrected transposition of the great arteries. Eur J Cardiothorac Surg， 2010， 38 （6）：728-734.
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| 18. |
Karl TR. The role of the Fontan operation in the treatment of congenitally corrected transposition of the great arteries. Ann Pediatr Cardiol， 2011， 4 （2）：103-110.
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| 19. |
Hörer J， Schreiber C， Krane S， et al. Outcome after surgical repair/palliation of congenitally corrected transposition of the great arteries. J Thorac Cardiovasc Surg， 2008， 56 （7）：391-397.
|
- 1. Hraska V， Duncan BW， Mayer JE Jr， et al. Long-term outcome of surgically treated patients with corrected transposition of the great arteries. J Thorac Cardiovasc Surg， 2005， 129 （1）：182-191.
- 2. Yacoub MH， Radley-Smith R， Maclaurin R. Two-stage operation for anatomical correction of transposition of the great arteries with intact interventricular septum. Lancet， 1977， 1 （8025）：1275-1278.
- 3. Jonas RA， Giglia TM， Sanders SP， et al. Rapid， two-stage arterial switch for transposition of the great arteries and intact ventricular septum beyond the neonatal period. Circulation， 1989， 80 （3 Pt 1）：I203-I208.
- 4. Lacour-Gayet F， Piot D， Zoghbi J， et al. Surgical management and indication of left ventricular retraining in arterial Switch for transposition of the great arteries with intact ventricular septum. Eur J Cardiothorac Surg， 2001， 20 （4）：824-829.
- 5. Quinn DW， Mcguirk SP， Metha C， et al. The morphologic left ventricle that requires training by means of pulmonary artery banding before the double-switch procedure for congenitally corrected transposition of the great arteries is at risk of late dysfunction. J Thorac Cardiovasc Surg， 2008， 135 （5）：1137-1144.
- 6. Le Bret E， Lupoglazoff JM， Borenstein N， et al. Cardiac “fitness” training：an experimental comparative study of three methods of pulmonary artery banding for ventricular training.Ann Thorac Surg， 2005， 79 （2）：198-203.
- 7. Jahangiri M， Redington AN， Elliott MJ， et al. A case for anatomic correction in atrioventricular discordance? Effects of surgery on tricuspid valve function. J Thorac Cardiovasc Surg， 2001， 121 （6）：1040-1045.
- 8. Di Donato RM， Fujii AM， Jonas R， et al. Age-dependent ventricular response to pressure overload. Considerations for the arterial switch operation. J Thorac Cardiovasc Surg， 1992， 104 （3）：713-722.
- 9. Auckland LM， Lambert SJ， Cummins P. Cardiac myosin light and heavy chain isotypes in tetralogy of Fallot. Cardiovasc Res， 1986， 20 （11）：828-836.
- 10. Bove EL. Congenitally corrected transposition of the great arteries：surgical options for biventricular repair. Progress in Pediatric Cardiology， 1999， 10 （1）：45-49.
- 11. Devaney EJ， Charpie JR， Ohye RG， et al. Combined arterial Switch and Senning operation for congenitally corrected transposition of the great arteries：patient selection and intermediate results. J Thorac Cardiovasc Surg， 2003， 125 （3）：500-507.
- 12. Winlaw DS， Mcguirk SP， Balmer C， et al. Intention-to-treat analysis of pulmonary artery banding in conditions with a morphological right ventricle in the systemic circulation with a view to anatomic biventricular repair. Circulation， 2005， 111 （4）：405-411.
- 13. 徐志伟， 苏肇伉， 丁文祥. 快速二期动脉转位术纠治新生儿完全性大动脉转位. 中国胸心血管外科临床杂志， 2004， 11 （1）：12-15.
- 14. 徐志伟， 沈佳， 刘锦纷， 等. 快速二期大动脉转位术的左心室功能判断. 中华外科杂志， 2011， 49 （2）：158-161.
- 15. 徐志伟， 沈佳. 快速二期大动脉转位术早期死亡危险因素. 中华胸心血管外科杂志， 2011， 27 （2）：87-89.
- 16. Mühlfeld C， Coulibaly M， Dörge H， et al. Ultrastructure of right ventricular myocardium subjected to acute pressure load. J Thorac Cardiovasc Surg， 2004， 52 （6）：328-333.
- 17. Metton O， Gaudin R， Ou P， et al. Early prophylactic pulmonary artery banding in isolated congenitally corrected transposition of the great arteries. Eur J Cardiothorac Surg， 2010， 38 （6）：728-734.
- 18. Karl TR. The role of the Fontan operation in the treatment of congenitally corrected transposition of the great arteries. Ann Pediatr Cardiol， 2011， 4 （2）：103-110.
- 19. Hörer J， Schreiber C， Krane S， et al. Outcome after surgical repair/palliation of congenitally corrected transposition of the great arteries. J Thorac Cardiovasc Surg， 2008， 56 （7）：391-397.
