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

Published online by Cambridge University Press:  19 August 2008

Philipp Bonhoeffer ,
G William Henry ,
Hiroshi Katayama ,
Robert Krzeski ,
Mario Carminati ,
Giancarlo Crupi  and
Lucio Parenzan
Philipp Bonhoeffer*
Affiliation:
From the Departments of Cardiology, Ospedali Riuniti di Bergamo, Bergamo
G William Henry
Affiliation:
Department of Pediatrics, The University of North Carolina, Chapel Hill
Hiroshi Katayama
Affiliation:
Department of Pediatrics, The University of North Carolina, Chapel Hill
Robert Krzeski
Affiliation:
Department of Pediatrics, The University of North Carolina, Chapel Hill
Mario Carminati
Affiliation:
From the Departments of Cardiology, Ospedali Riuniti di Bergamo, Bergamo
Giancarlo Crupi
Affiliation:
From the Department of Cardiac Surgery, Ospedali Riuniti di Bergamo, Bergamo
Lucio Parenzan
Affiliation:
From the Department of Cardiac Surgery, Ospedali Riuniti di Bergamo, Bergamo
*
Dr. Philipp Bonhoeffer, Department of Cardiology, Ospedali Riuniti di Bergamo, Largo Barozzi 1,24100 Bergamo, Italy. Tel. (39)35-269298; Fax. (39)35-259849
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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.

Keywords

Transpositionventricular preparationarterial switchcardiac catheterization
Type
Preliminary Reports
Information
Cardiology in the Young , Volume 2 , Issue 1 , January 1992 , pp. 85 - 88
Copyright
Copyright © Cambridge University Press 1992

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References

1.Nair, KJ, Cutilletta, AF, Zak, I, Koide, T, Rabinowitz, M. Biochemical correlates of cardiac hypertrophy. Circulation Res 1968; 23: 541–562.CrossRefGoogle ScholarPubMed
2.Koide, T, Rabinowitz, M. Biochemical correlates of cardiac hypertrophy. Circulation Res 1969; 24: 9–18.CrossRefGoogle ScholarPubMed
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: 970–977.Google Scholar
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; 339–343.Google Scholar
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): I–203.Google Scholar
6.Jonas, RA. Update on the rapid two stage arterial switch procedure. Cardiol Young 1991; 1: 99–100.CrossRefGoogle ScholarPubMed
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: 582–586.CrossRefGoogle ScholarPubMed
8.Dajee, H, Benson, L, Laks, H. An improved method of pulmo nary artery banding. Ann Thorac Surg 1984; 37: 254–257.CrossRefGoogle Scholar
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: 430–435.Google Scholar
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: 436–444.CrossRefGoogle ScholarPubMed
11.Solis, E, Heck, CF, Seward, JB, Kaye, MP. Percutaneously adjustable pulmonary artery band. Ann Thorac Surg 1986; 41: 65–69.CrossRefGoogle ScholarPubMed
12.Solis, E, Bell, DAlboliras, H, Seward, J, Kaye, MP. Left ventricular preparation with an extrathoracically adjustable balloon occluder. Ann Thorac Surg 1987; 44: 58–61.Google Scholar