MEC国試速報掲示板
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emedicineからPA banding を行うのはECD, d-TGAなどですね。 ゆえに答えはd, eで確実です。 以下emedicineからの引用。 "children were treated with pulmonary artery banding in infancy to protect the pulmonary vasculature from excessive blood flow and development of pulmonary vascular disease. Patients were referred for corrective surgery when older than 3-4 years. " Endocardial Cushion Defects Treatment & Management, emedicine PA bandingのindicationsにあたるのは、 "(1) those with pulmonary overcirculation and left-to-right shunting who require reduction of pulmonary blood flow (PBF) as a staged approach to more definitive repair and (2) those with transposition of the great arteries (TGA) who require training of the left ventricle (LV) as a staged approach to the arterial switch procedure." Pulmonary Artery Banding, emedicine まず肺血流が正常より増えるものを選ぶと考えたが、違ったらしい。indicationの(2)を知らなかった。根治手術に備えてまさかTrainingする意味があるとは! 医学って奥深い。
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