Document Detail


A method of transcutaneously adjustable pulmonary artery banding for staged left ventricular retraining.
MedLine Citation:
PMID:  22325326     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The placement of a pulmonary artery band to retrain the left ventricle often requires reoperation for band adjustment. We describe an effective technique for the placement of a transcutaneously adjustable pulmonary artery band that allows adjustments to be made without the need for repeat sternotomy.
METHODS: Using standard catheters, an adjustable band was fashioned and placed around the pulmonary artery with the control end positioned in the subcutaneous tissue of the anterior chest wall. Tightening or loosening of the band can be subsequently performed by exposing the control end without the need for reopening the chest.
RESULTS: From 1995 to 2011, 11 patients underwent placement of a transcutaneously adjustable pulmonary artery band for the purpose of retraining the morphologic left ventricle for a subsequent arterial switch operation. One or more band adjustments were required in 6 patients (1 loosened and 5 tightened, 55%) at a mean of 281 days (median, 98; range, 0-917) after initial band placement. All were accomplished successfully by exposing the band in the subcutaneous tissue of the anterior chest wall and performing the adjustment under Doppler echocardiographic guidance.
CONCLUSIONS: This technique affords the operating surgeon the freedom to apply the band very gradually, erring on the side of safety, and facilitates a gradual increase in ventricular afterload that can be performed as a minor procedure.
Authors:
Daniel J Dibardino; Kellianne Kleeman; Edward L Bove
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Publication Detail:
Type:  Journal Article     Date:  2012-02-09
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  144     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-17     Completed Date:  2012-11-30     Revised Date:  2013-04-23    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  553-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Section of Cardiac Surgery, Division of Pediatric Cardiac Surgery, CS Mott Children’s Hospital, University of Michigan Medical School, 5144 CVC/SPC 5864, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5864, USA. Daniel.DiBardino@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Blood Pressure
Cardiac Catheterization
Cardiac Surgical Procedures / instrumentation
Catheters
Child
Child, Preschool
Dissection
Echocardiography, Doppler
Equipment Design
Humans
Infant
Ligation
Michigan
Pulmonary Artery / physiopathology,  surgery*,  ultrasonography
Recovery of Function
Sternotomy
Time Factors
Transposition of Great Vessels / physiopathology,  surgery*,  ultrasonography
Treatment Outcome
Ventricular Function, Left*
Comments/Corrections
Comment In:
J Thorac Cardiovasc Surg. 2013 Apr;145(4):1144   [PMID:  23497945 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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