Skip to main content Accessibility help
×
Home

Preparation of the “pulmonary ventricle” for arterial switch by adjustable intravascular balloon outflow obstruction—an experimental approach in a lamb model

  • Philipp Bonhoeffer (a1), G William Henry (a2), Hiroshi Katayama (a2), Robert Krzeski (a2), Mario Carminati (a1), Giancarlo Crupi (a3) and Lucio Parenzan (a3)...

Abstract

Surgical banding of the pulmonary artery in patients with transposition of the great arteries leads to a rapid increase of the left ventricular mass. The purpose of this animal experiment was to induce ventricular systolic hypertension in the “subpulmonary ventriclerdquo; by intravascular obstruction to pulmonary flow. The first experiment was performed in an anesthetized animal with an open thorax. A balloon-tipped catheter was introduced into the femoral vein and advanced to the pulmonary artery. The balloon was positioned in the pulmonary trunk and was progressively inflated until a systemic pressure was achieved in the “pulmonary ventricle”. This was accomplished within 40 minutes without a significant reduction in cardiac output, which was continuously monitored by an electromagnetic flowprobe. In the second experiment an analogous procedure was performed in a closed chest, awake, spontaneously breathing animal. The catheter was maintained in proper place for 24 hours. Subsequent macroscopic examination of the heart demonstrated a remarkable increase in the ventricular mass. The results of this preliminary experiment demonstrate the possibility for creating “intraluminal pulmonary banding”. The potential advantages of this technique are the nonsurgical approach and the ability to adjust the grade of obstruction to pulmonary flow.

Copyright

Corresponding author

Dr. Philipp Bonhoeffer, Department of Cardiology, Ospedali Riuniti di Bergamo, Largo Barozzi 1,24100 Bergamo, Italy. Tel. (39)35-269298; Fax. (39)35-259849

References

Hide All
1.Nair, KJ, Cutilletta, AF, Zak, I, Koide, T, Rabinowitz, M. Biochemical correlates of cardiac hypertrophy. Circulation Res 1968; 23: 541562.
2.Koide, T, Rabinowitz, M. Biochemical correlates of cardiac hypertrophy. Circulation Res 1969; 24: 918.
3.Izumo, S, Lompre, AM, Matsuoka, R, Koren, G, Schwartz, K, Nadal-Ginard, B, Mahdavi, V. Myosin heavy chain messenger RNA and protein isoform transitions during cardiac hypertrophy. J Clin Invest 1987; 79: 970977.
4.Izumo, S, Nadal-Ginard, B, Mahdavi, V. Protooncogene induction and reprogramming of cardiac gene expression produced by pressure overload. Proc Natl Acad Sci USA 1988; 339343.
5.Jonas, RA, Giglia, TM, Sanders, SP, Wernovsky, G, Nadal-Ginard, B, Mayer, JE, Rapid, Castañeda AR., Two-stage arterial switch for transposition of the great arteries and intact ven tricular septum beyond the neonatal period. Circulation 1989; 80 (Suppl I): I203.
6.Jonas, RA. Update on the rapid two stage arterial switch procedure. Cardiol Young 1991; 1: 99100.
7.Muraoka, R, Yokota, M, Aoshima, M, Nomoto, S, Kyoku, I, Kobayashi, A, Nakano, H, Ueda, K, Saito, A. Extrathoracically adjustable pulmonary artery banding. J Thorac Cardiovasc Surg 1983; 86: 582586.
8.Dajee, H, Benson, L, Laks, H. An improved method of pulmo nary artery banding. Ann Thorac Surg 1984; 37: 254257.
9.Lange, PE, Sievers, HH, Nurnberg, JH, Engler, K, Pilarczyk, J, Onnasch, DGW, Bernhard, A, Heintzen, PH. A new device for slow progressive narrowing of vessels. Basic Res Cardiol 1985; 80: 430435.
10.Lange, PE, Nurnberg, JH, Sievers, HH, Onnasch, DGW, Bernhard, A, Heintzen, PH. Response of the right ventricle to progressive pressure loading in pigs. Basic Res Cardiol 1985; 80: 436444.
11.Solis, E, Heck, CF, Seward, JB, Kaye, MP. Percutaneously adjustable pulmonary artery band. Ann Thorac Surg 1986; 41: 6569.
12.Solis, E, Bell, DAlboliras, H, Seward, J, Kaye, MP. Left ventricular preparation with an extrathoracically adjustable balloon occluder. Ann Thorac Surg 1987; 44: 5861.

Keywords

Preparation of the “pulmonary ventricle” for arterial switch by adjustable intravascular balloon outflow obstruction—an experimental approach in a lamb model

  • Philipp Bonhoeffer (a1), G William Henry (a2), Hiroshi Katayama (a2), Robert Krzeski (a2), Mario Carminati (a1), Giancarlo Crupi (a3) and Lucio Parenzan (a3)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed