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Banding of the pulmonary trunk in preparation for a Fontan operation

Published online by Cambridge University Press:  19 August 2008

Takahiko Sakamoto
Affiliation:
Division of Cardiovascular Surgery and NaganoChildren’s Hospital, Nagano, Japan
Yorikazu Harada*
Affiliation:
Division of Cardiovascular Surgery and NaganoChildren’s Hospital, Nagano, Japan
Takamasa Takeuchi
Affiliation:
Division of Cardiovascular Surgery and NaganoChildren’s Hospital, Nagano, Japan
Katsumasa Morishima
Affiliation:
Division of Cardiovascular Surgery and NaganoChildren’s Hospital, Nagano, Japan
Gengi Satomi
Affiliation:
Division of Pediatric Cardiology, and NaganoChildren’s Hospital, Nagano, Japan
Satoshi Yasukochi
Affiliation:
Division of Pediatric Cardiology, and NaganoChildren’s Hospital, Nagano, Japan
Yoshinori Ohta
Affiliation:
Division of Cardiovascular Surgery and NaganoChildren’s Hospital, Nagano, Japan
*
Dr Yorikazu Harada MD, Division of Cardiovascular Surgery, Nagano Children’s Hospital, 3100, Toyoshina, Toyoshina-machi, Minamiazumi-gun, Nagano 399–82, Japan.. Tel: 81–263–73–6700; Fax: 81–263–73–5432

Abstract

Banding of the pulmonary trunk is an important surgical procedure for patients who have con genital cardiac malformations with unrestricted pulmonary flow. We propose a new concept for determining in such circumstances the most appropriate length of the band used to constrict the pulmonary trunk in preparation for a Fontan operation. We studied 14 patients undergoing banding of the pulmonary trunk and measured the following parameters: diameter of aorta, diameter of pulmonary trunk, length of pulmonary arterial band and maximum flow velocity across the banded segment. We calculated an index from our orig inal parameter based on the formula; length of band/(diameter of aorta diameter of pulmonary trunk). The diameter of aorta was 9.5 ± 1.4 mm, and that of the pulmonary trunk was 9.6 ± 2.3 mm. The length of the band was 16.5 ± 3.4 mm, giving a calculated index of 0.188 ± 0.038. The maximum flow velocity was 4.02 ± 0.46 m/s. No correlation was found between the length of the band and body weight, and also no correlation was found between the length of the band and maximum flow velocity. The calculated index had a negative correlation with the maximum velocity of flow across the band (y = -8.13x + 5.56, R = 0.74, p < 0.01). We believe that the proposed index is a useful guide in determining the length of a pulmonary band when preparing patients for a Fontan operation.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1999

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