Nova bandagem ajustável das artérias pulmonares na Síndrome de Hipoplasia de Câmaras Esquerdas

Abstract

Objective: Hypoplastic left heart syndrome remains a challenge for worldwide surgeons. Initial palliation employing bilateral pulmonary artery banding along with ductal stent implantation and atrial septostomy has been proposed as an alternative approach. However, the surgically placed bands are fixed and may become inadequate after sternum closure or with somatic growth of the patient. We describe the first case in which a neonate with hypoplastic left heart syndrome was initially managed using a mini banding system that allows for fine percutaneous adjustments of pulmonary blood flow.Method: Through a mid sternotomy, a 5 day-old neonate underwent bilateral pulmonary artery banding using this new system combined with placement of a main pulmonary artery to innominate artery shunt.Results: The patient had an uneventful postoperative course. Three percutaneous adjustments of the banding system were necessary to keep the arterial oxygen saturation in the 75%-85% range. On the 48 th day of life, she was 42ASSAD, RS ET AL -A novel adjustable pulmonary artery banding system for hypoplastic left heart syndrome Braz J Cardiovasc Surg 2007; 22(1): 41-48

Dominância coronariana na síndrome da hipoplasia do coração esquerdo

“…Although the HLHS is extensively studied, the surgical treatment performed by the Norwood-type palliative surgery [3][4] or by the so-called hybrid procedures [5][6] has satisfactory results in many centers [7][8]. Nevertheless, this disease still has a high mortality rate between the first and second stage, when compared to other diseases treated as univentricular physiology.…”