Pulmonary Artery Banding in Infants with VSD and Congestive Heart Failure

於小兒心室中隔缺損症致心髒衰竭時主肺動脈帶束術的適應與效果

黃炫鈆(Iisuan-Chiene Huang) ； 呂鴻基(Hung-Chi Lue) ； 洪啓仁(Chi-Ren Hung)

《Acta Paediatrica Sinica》 13卷3期 (1972/09) Pp. 117-124

摘要

民國五十五年至六十年間共有十二例心室中隔缺損的小兒在臺大醫院施行肺動脈帶束術，其中九例是在一歲以前施行。施行該術的適應證如下：（一）在心室有大的左至右血液短流且導致頑強性心臓衰竭。（二）反覆發生呼吸道感染。（三）發育阻滯。
全部例在術後都有顯著臨床徵候上的改善。長期追踪觀察的十二例中，二例死亡，但與手術本身無關；一例於術後29日死於肺炎，另一例即於術後二年因麻疹併發肺炎而死亡。其餘十例起居皆正常。
著者認爲心室中隔缺損症導致心臓衰竭時，若予以內科藥物療法，仍無效時，肺動脈帶束術乃不失爲安全而有效的治標方法。

並列摘要

Twelve infants and children with ventricular septal defect were subjected to banding of the pulmonary artery between 1966 and 1971 at the National Taiwan University Hospital. In nine of the twelve cases the procedure was done under the age of one year. The indications for the banding were presence of large left-to-right shunts at the ventricular level, intractable congestive heart failure, repeated episodes of respiratory infection and failure to thrive. Relief of the signs and symptoms of heart failure was striking in all cases. No immediate surgical mortality was noted. Late death occurred in 2 cases: one died of pneumonia 29 days after the banding and another died of measles and pneumonia two years following the surgery. All the 10 cases surviving and doing well are planned to undergo a repair of the ventricular sepal defect in due time. At present, we consider that banding of the pulmonary artery is a safe and effective surgical palliative procedure for infants with congestive heart failure due to large ventricular septal defect, and is to be recommended should the medical management have been proven as futile.