Pulmonary Artery Banding for Children With Dilated Cardiomyopathy: US Experience

Q2 Medicine
Zachary A. Spigel MD , Anees Razzouk MD , John J. Nigro MD , Tara B. Karamlou MD, MSc , Minoo N. Kavarana MD , Mark E. Roeser MD , Iki Adachi MD
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引用次数: 7

Abstract

Pulmonary artery band placement is a recently described therapeutic strategy for dilated cardiomyopathy with preserved right ventricular function, originally reported from Germany.1 We present the results of the multicenter retrospective study of pulmonary artery band experience in the United States, with comparison to the German experience. Five centers contributed a total 14 patients (median age 5 months, interquartile range 3.5–10). Mechanical ventilation was required in 9/12 (75%) patients and inotropes were used in 13/14 (93%) patients preoperatively. Ultimately, 4 (29%) patients experienced cardiac recovery, 8 (57%) were bridged to cardiac transplantation (6 with ventricular assist device placement), and 2 (14%) died. Although both the US and Germany series demonstrated high prevalence of achieving patients’ individual target (either cardiac recovery or transplant), the mode of success was different (recovery rate: <1/3 in the United States and >2/3 in Germany). Lower recovery rate may be a reflection of sicker preoperative status, and thereby a more advanced stage of heart failure (preoperative intubation: >2/3 in the United States vs <1/3 in Germany). Further studies would be warranted to gain more insight into patient selection as well as optimal timing for the intervention.

扩张型心肌病患儿肺动脉绑扎术:美国经验
肺动脉带置入术是最近被描述的一种治疗扩张型心肌病的策略,保留了右室功能,最初来自德国。我们提出了美国肺动脉带置入术的多中心回顾性研究的结果,并与德国的经验进行了比较。5个中心共纳入14例患者(中位年龄5个月,四分位数范围3.5-10)。术前9/12(75%)患者需要机械通气,13/14(93%)患者使用肌力。最终,4例(29%)患者心脏恢复,8例(57%)进行心脏移植(6例植入心室辅助装置),2例(14%)死亡。尽管美国和德国的系列都显示了患者个体目标(心脏恢复或移植)的高患病率,但成功的模式不同(美国和德国的康复率分别为1/3和2/3)。较低的恢复率可能反映了术前病情较重,因此心衰阶段较晚期(术前插管:美国为2/3,德国为1/3)。进一步的研究将保证对患者的选择以及干预的最佳时机有更多的了解。
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来源期刊
CiteScore
3.80
自引率
0.00%
发文量
7
期刊介绍: The Pediatric Cardiac Surgery Annual is a companion to Seminars in Thoracic and Cardiovascular Surgery . Together with the Seminars, the Annual provides complete coverage of the specialty by focusing on important developments in pediatric cardiac surgery. Each annual volume has an expert guest editor who invites prominent surgeons to review the areas of greatest change in pediatric cardiac surgery during the year. Topics include 1) Complete Atrioventricular Canal; 2) New Concepts of Cardiac Anatomy and Function -- The Helical Heart; 3) Valve Reconstruction (Replacement) in Congenital Heart Disease; 4) Evolving Developments in Congenital Heart Surgery.
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