Induction of right ventricular hypertrophy with obstructing balloon catheter. Nonsurgical ventricular preparation for the arterial switch operation in simple transposition.
Induction of right ventricular hypertrophy with obstructing balloon catheter. Nonsurgical ventricular preparation for the arterial switch operation in simple transposition.
复制标题
用阻塞球囊导管诱导右心室肥厚。
DOI：
10.1161/01.cir.88.4.1765
复制
发表时间：
1993
期刊：
影响因子：
37.8
通讯作者：
Henry,GW
中科院分区：
文献类型：
--
作者：
Katayama,H;Krzeski,R;Frantz,EG;Ferreiro,JI;Lucas,CL;Ha,B;Henry,GW
背景最近，报道了一种快速二期动脉转换术(ASO)治疗低左室压大动脉转位(TGA)患者的成功结果。在此过程中，肺动脉环扎术和ASO之间的间隔约为1周。这一成功的结果表明，在ASO前使用阻塞性球囊导管进行非手术的脑室准备是可行的。方法和结果将5F房间隔造口术导管直接插入6只20~38日龄羔羊的主肺动脉。在关闭胸腔后，气球每天充气两次，持续2至2.5小时。手术连续进行4天。最后一次充气后，将右室重量与总重量的比值与年龄匹配的对照组进行比较。末次充气后，右室收缩期峰压和右室/主动脉收缩期峰压比值分别升至85.6±4.7 mm Hg(平均值+/-1SD)和79.6+/-8.6%。球囊扩张后右室重量占总心肌重量的百分比显著高于对照组(29.5±-1.2%比23.0+/-1.0%；P<；0.0001)和干心重量(27.0+/-2.0%比21.0+/-1.1%；P<；0.0001)。TGA中ASO的非手术脑室准备是可行的。
BACKGROUNDRecently, a successful result with a rapid two-stage arterial switch operation (ASO) was reported for patients with transposition of the great arteries (TGA) with low left ventricular pressure. In this procedure, the interval between pulmonary arterial banding and ASO was approximately 1 week. This successful result indicates the possibility of a nonsurgical ventricular preparation procedure using an obstructing balloon catheter prior to ASO.METHODS AND RESULTSA 5F atrioseptostomy catheter was inserted directly into the main pulmonary artery in six lambs aged 20 to 38 days. After the chest was closed, the balloon was inflated twice a day for a period of 2 to 2.5 hours. This procedure was performed for 4 consecutive days. After the final inflation, the ratio of right ventricular weight to total ventricular weight was compared with that in an age-matched control group. After the final inflation, the peak systolic right ventricular pressure and the percentage of peak systolic right ventricular to peak systolic aortic pressure rose to 85.6 +/- 4.7 mm Hg (mean +/- 1 SD) and 79.6 +/- 8.6%, respectively. The percentages of the right ventricular weight to the total ventricular weight were significantly higher after the balloon inflation than those in the control group in terms of wet heart weight (29.5 +/- 1.2% versus 23.0 +/- 1.0%; P < .0001) and dry heart weight (27.0 +/- 2.0% versus 21.0 +/- 1.1%; P < .0001).CONCLUSIONSThe myocardial mass in the right ventricle increased after 4 days of intermittently applied pressure overload. Nonsurgical preparation of the ventricle for ASO in TGA is feasible.