Friedli B, Oberhänsli I, Faidutti B
Department of Paediatrics Faculty of Medicine Geneva, Switzerland.
Thorac Cardiovasc Surg. 2000 Dec;48(6):319-22. doi: 10.1055/s-2000-8341.
Interventional catheterization is an alternative to surgery for some congenital heart defects. For other malformations, the surgeon and the interventionist will join in an effort to obtain an optimal result: the typical example is pulmonary atresia with VSD and aortopulmonary collaterals. In other cases, the cardiologist may be called upon to intervene with catheter techniques to correct sequelae or residual lesions after surgical correction, avoiding redo surgery. Most often, the task consists of opening stenoses by balloon dilatation and/or stenting the main targets being pulmonary artery branch stenoses, venous obstructions after Mustard procedure, and recoarctations. Whereas simple balloon dilatation of recoarctation often brings good results, stents are often needed to obtain optimal results in pulmonary branch stenoses. Stenting of pulmonary veins has been disappointing. Closing unwanted vessels and defects is another task for the interventional cardiologist after cardiac surgery. Here, the most frequent procedure is closing aortopulmonary collaterals in pulmonary atresia and VSD after corrective surgery. Advantages and limitations of these procedures are discussed.
对于某些先天性心脏缺陷，介入导管插入术是手术的一种替代方法。对于其他畸形，外科医生和介入专家将共同努力以获得最佳结果：典型的例子是室间隔缺损合并肺动脉闭锁及体肺侧支循环。在其他情况下，心脏病专家可能会被要求采用导管技术干预，以纠正手术矫正后的后遗症或残余病变，避免再次手术。大多数情况下，任务包括通过球囊扩张和/或置入支架来打开狭窄，主要目标是肺动脉分支狭窄、Mustard手术后的静脉阻塞以及再狭窄。虽然单纯球囊扩张治疗再狭窄通常能取得良好效果，但在肺动脉分支狭窄中往往需要置入支架才能获得最佳效果。肺静脉置入支架的效果并不理想。封堵不必要的血管和缺损是心脏手术后介入心脏病专家的另一项任务。在此，最常见的手术是在矫正手术后封堵肺动脉闭锁合并室间隔缺损中的体肺侧支循环。本文讨论了这些手术的优缺点。
