Advertisement

Interpretation of the echocardiographic pressure gradient across a pulmonary artery band in the setting of a univentricular heart

  • Shane M. Tibby
  • Andrew Durward
Chapter

Abstract

Pulmonary artery (PA) banding has been established as a palliative surgical technique for congenital heart defects for over 50 years [1]. With the advent of earlier corrective surgery, the indications for PA banding have changed over time [2, 3]. Currently these include: (a) limitation of pulmonary blood flow in the setting of an excessive left-toright shunt; (b) regulation of pulmonary blood flow in the univentricular circulation; and (c) a training procedure for the left ventricle prior to conversion to the systemic pumping chamber (late presentation of D-transposition of the great arteries, or prior to a double-switch procedure with L-transposition).

Keywords

Oxygen Saturation Hypoplastic Left Heart Syndrome Arterial Oxygen Saturation Pulmonary Artery Band Central Venous Oxygen Saturation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Muller WH Jr, Danimann JF Jr (1952) The treatment of certain congenital malformations of the heart by the creation of pulmonic stenosis to reduce pulmonary hypertension and excessive pulmonary blood flow; a preliminary report. Surg Gynecol Obstet 95:213–219PubMedGoogle Scholar
  2. 2.
    Corno AF (2005) Pulmonary artery banding. Swiss Med Wkly 135:515–519PubMedGoogle Scholar
  3. 3.
    Plunkett M, Laks H. Pulmonary Artery Banding. E-medicine http://www.emedicine.com/ped/topic2900.htm accessed 28 March 2007
  4. 4.
    Granton JT, Rabinovitch M (2002) Pulmonary arterial hypertension in congenital heart disease. Cardiol Clin 20:441–457PubMedCrossRefGoogle Scholar
  5. 5.
    Pinho P, von Oppell UO, Brink J, Hewitson J (1997) Pulmonary artery banding: adequacy and long-term outcome. Eur J Cardiothorac Surg 11:105–111PubMedCrossRefGoogle Scholar
  6. 6.
    Fyfe DA, Currie PJ, Seward JB, Tajik AJ, Reeder GS, Mair DD, Hagler DJ (1984) Continuous-wave Doppler determination of the pressure gradient across pulmonary artery bands: hemodynamic correlation in 20 patients. Mayo Clin Proc 59:744–750PubMedGoogle Scholar
  7. 7.
    Wernovsky G, Bove EL (1998) Single ventricle lesions. In: Chang AC, Hanley FL, Wernovsky G, Wessel DL (eds) Pediatric cardiac intensive care. Lippincott Williams and Wilkins, Philadelphia, pp 275–276Google Scholar
  8. 8.
    Corno AF (2000) Revised pulmonary artery banding. Ann Thorac Surg 69:1295–1296PubMedCrossRefGoogle Scholar
  9. 9.
    Barnea O, Austin EH, Richman B, Santamore WP (1994) Balancing the circulation: theoretic optimization of pulmonary/systemic flow ratio in hypoplastic left heart syndrome. J Am Coll Cardiol 24:1376–1381PubMedCrossRefGoogle Scholar
  10. 10.
    Charpie JR, Dekeon MK, Goldberg CS, Mosca RS, Bove EL, Kulik TJ (2001) Postoperative hemo-dynamics after Norwood palliation for hypoplastic left heart syndrome. Am J Cardiol 87:198–202PubMedCrossRefGoogle Scholar
  11. 11.
    Taeed R, Schwartz SM, Pearl JM, Raake JL, Beekman RH III, Manning PB, Nelson DP (2001) Unrecognized pulmonary venous desaturation early after Norwood palliation confounds Gp:Gs assessment and compromises oxygen delivery. Circulation 103:2699–2704PubMedGoogle Scholar
  12. 12.
    Albus RA, Trusler GA, Izukawa T, Williams WG (1984) Pulmonary artery banding. J Thorac Cardiovasc Surg 88:645–653PubMedGoogle Scholar
  13. 13.
    Rivers EP, Ander DS, Powell D (2001) Central venous oxygen saturation monitoring in the critically ill patient. Curr Opin Crit Care 7:204–211PubMedCrossRefGoogle Scholar
  14. 14.
    Li J, Zhang G, McCrindle BW, Holtby H, Humpl T, Cai S, Caldarone CA, Redington AN, Van Arsdell GS (2007) Profiles of hemo-dynamics and oxygen transport derived by using continuous measured oxygen consumption after the Norwood procedure. J Thorac Cardiovasc Surg 133:441–448PubMedCrossRefGoogle Scholar
  15. 15.
    Akintuerk H, Michel-Behnke I, Valeske K, Mueller M, Thul J, Bauer J, Hagel KJ, Kreuder J, Vogt P, Schranz D (2003) Stenting of the arterial duct and banding of the pulmonary arteries: basis for combined Norwood stage I and II repair in hypoplastic left heart. Circulation 105:1099–1103CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • Shane M. Tibby
    • 1
  • Andrew Durward
    • 1
  1. 1.Paediatric Intensive Care Unit, Evelina Children’s Hospital, Guy’s and Saint Thomas’ NHS TrustLondonUK

Personalised recommendations