Modification of Trusler's Formula for the Pulmonary Artery Banding

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• 作者：Ghassan Baslaim
• 关键词：Pulmonary blood flow ; Congenital heart defects ; Surgery
• 刊名：Heart, Lung and Circulation
• 出版年：2009
• 出版时间：October 2009
• 年：2009
• 卷：18
• 期：5
• 页码：353-357
• 全文大小：80 K

文摘

Background

The major difficulty of pulmonary artery banding (PAB) is optimal intraoperative adjustment. In this study, a target intraoperative shunt ratio (Q_p/Q_s) was utilised to evaluate a fixed Trusler's formula for the degree of PAB of infants destined for either univentricular or biventricular surgical route.

Methods

Ten consecutive infants (median age, 1.62 months) undergoing PAB through median sternotomy were studied. A fixed Trusler's formula (20 mm + 1 mm/kg body weight) was used to set the initial band size, and subsequent intraoperative adjustment was based on target Q_p/Q_s (using oxymetric data). Suitable target Q_p/Q_s was set ≤0.5 for the biventricular repair group (six patients) and ≤0.3 for the univentricular palliation group (four patients).

Results

In the biventricular group, the target mean Q_p/Q_s of 0.4 was achieved according to the fixed formula. However the band size was narrower in the univentricular group by 2.25 mm to achieve the target mean Q_p/Q_s of 0.27 instead of a higher level (2.2) with the fixed formula.

Conclusion

Using the intraoperative Q_p/Q_s calculation, the circumference of the band was in agreement with the fixed formula of Trusler for the biventricular repair group, however a narrower band size is recommended for the univentricualr palliation group.