Intraoperative echocardiographic indicator for optimal bilateral pulmonary artery banding.

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

General Thoracic and Cardiovascular Surgery Pub Date : 2025-05-14 DOI:10.1007/s11748-025-02156-9

Tetsuri Takei, Yukihiro Kaneko, Ryoichi Kondo, Naho Morisaki, Ikuya Achiwa

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引用次数: 0

Abstract

Background: We aimed to establish the most predictive echocardiographic indicator of appropriate tightness of bilateral pulmonary artery banding (BPAB).

Methods: In part A of the study, we retrospectively analyzed the peak flow velocity (PV) and nadir flow velocity (NV) across the band and the ratio of NV to PV (velocity ratio: VR) to determine appropriate band tightness. In part B, we prospectively studied the utility of the best predictive indicators.

Results: Thirty-one patients undergoing BPAB were enrolled in part A and identified as having appropriate pulmonary blood flow (APF), high pulmonary blood flow (HPF), or low pulmonary blood flow (LPF) during the postoperative period. The areas under the receiver operating characteristic curve (AUC) for HPF were 0.92 for PV, 0.99 for NV, and 0.99 for VR; the velocity thresholds were 2.47, 1.15, and 0.45 m/sec, respectively. For LPF, the AUCs were 0.63 for PV, 0.78 for NV, and 0.81 for VR, and the velocity thresholds were 2.70, 1.59, and 0.58 m/sec, respectively; thus, VR best indicated band tightness. In part B, we performed BPAB in 34 patients, adjusting the bands to achieve VRs between 0.45 and 0.58. The prevalence of HPF was significantly lower in part B than in part A, whereas those of LPF did not differ.

Conclusion: In BPAB, we consider the optimal range of VR at banding site is between 0.45 and 0.58.

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最佳双侧肺动脉束带术中超声心动图指标。

背景：我们的目的是建立最具预测性的双侧肺动脉束带松紧度（BPAB）超声心动图指标。方法：在研究的A部分中，我们回顾性分析了带间的峰值流速（PV）和最低点流速（NV）以及NV与PV的比值（流速比：VR），以确定合适的带紧度。在第二部分，我们前瞻性地研究了最佳预测指标的效用。结果：A部分纳入31例接受BPAB的患者，并确定其在术后期间具有适当的肺血流量（APF），高肺血流量（HPF）或低肺血流量（LPF）。HPF的受者工作特征曲线下面积（AUC）分别为：PV 0.92、NV 0.99、VR 0.99；速度阈值分别为2.47、1.15和0.45 m/sec。LPF的auc分别为0.63、0.78和0.81，速度阈值分别为2.70、1.59和0.58 m/sec；因此，VR最能指示腕带松紧度。在B部分，我们对34例患者进行了BPAB，调整带使vr值在0.45 - 0.58之间。B组HPF患病率显著低于A组，而LPF患病率无显著差异。结论：在BPAB中，我们认为绑带部位VR的最佳范围为0.45 ~ 0.58。

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来源期刊

General Thoracic and Cardiovascular Surgery Medicine-Pulmonary and Respiratory Medicine

CiteScore

2.70

自引率

8.30%

发文量

142

期刊介绍： The General Thoracic and Cardiovascular Surgery is the official publication of The Japanese Association for Thoracic Surgery and The Japanese Association for Chest Surgery, the affiliated journal of The Japanese Society for Cardiovascular Surgery, that publishes clinical and experimental studies in fields related to thoracic and cardiovascular surgery.