The utility of aortic blood flow measurements in the prediction of pulmonary artery banding outcome

Yasuhiro Kotani, Michael Coles, Nimesh D. Desai, Osami Honjo, Christopher A. Caldarone, John G. Coles, Glen S. Van Arsdell

Research output: Contribution to journalArticle

Abstract

Background The purpose of this study was to evaluate the clinical utility of intraoperative aortic blood flow measurements on clinical outcome in patients undergoing pulmonary artery banding (PAB). Methods We reviewed 12 patients who underwent a PAB between September 2008 and March 2013 who also had intraoperative aortic blood flow measurements. Diagnosis included biventricular physiology in 6, single-ventricle physiology in 4, and inadequate systemic ventricle in 2 patients. Aortic blood flow was measured at the time of surgery by Transonic flow probe (Transonic Systems Inc, Ithaca, NY). Aortic flow, intraoperative hemodynamics, and clinical outcomes were analyzed to determine the potential predictive utility of intraoperative variables on postoperative outcomes. Results The aortic flow increased after PAB from 1.56 ± 0.73 to 2.20 ± 1.10 L · min-1 · m-2 (41.0% increase; p = 0.001). The efficacy of the PAB procedure was found to be directly related to the percentage increase in aortic blood flow measured intraoperatively. Three patients with less than 20% increase in aortic blood flow died, required re-PAB, or developed ventricular dysfunction, while patients with successful PAB had more than 40% increase in aortic blood flow. The percentage increase in aortic blood flow was not predictable based on pre-band or post-band absolute aortic blood flow measurements. The percentage increase in aortic blood flow was inversely correlated to the tightness of the PAB as defined relative to that predicted by the Trusler formula (r = 0.67; p = 0.01). Conclusions This study identifies the change in the aortic blood flow as a new, physiologically based parameter to help predict PAB outcome.

Original languageEnglish
Pages (from-to)2096-2100
Number of pages5
JournalAnnals of Thoracic Surgery
Volume99
Issue number6
DOIs
Publication statusPublished - Jun 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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