修正大血管転位症に対するダブルスイッチ手術を目的とした肺動脈絞扼術による左室トレーニングの検討

概要

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Some patients with corrected transposition of the great arteries(CCTGA) may be eligible for double switch operation(DSO). However, the candidates for DSO with small VSD or without VSD usually require pulmonary artery banding(PAB) as left ventricular training prior to DSO due to decreased LV pressure. The aim of this study is to compare the outcome and hemodynamic parameters in patients who could attain DSO and those in patients who could not attain DSO after PAB. Thirteen patients underwent PAB for LV training between 1989 and 2006. Seven patients attained DSO after initial or second PAB, whereas six could not attain DSO. Six of seven who underwent DSO had good results. In six patients who could not attain DSO after PAB, one patient had hospital death and two had late deaths. Age and advanced A-V block might be the risk factors in these patients. In conclusion, the outcome of DSO subsequent to PAB is satisfactory. However, some patients whose LV function was not improved by initial PAB and could not attain DSO showed poor prognosis.
日本循環制御医学会の論文