Modification of Trusler's formula for the pulmonary artery banding.
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 (20mm+1mm/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 <or=0.5 for the biventricular repair group (six patients) and <or=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.


CONCLUSIONS
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.
Baslaim
Ghassan
G
Division of Cardiothoracic Surgery, Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Center, Jeddah 21499, Saudi Arabia. gbaslaim@hotmail.com
D006348:Cardiac Surgical Procedures / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D011651:Pulmonary Artery