Villain E, Saliba Z, Bonhoeffer P, Iserin L, Bonnet D, Kachaner J
Service de cardiologie pédiatrique, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75 015 Paris.
Arch Mal Coeur Vaiss. 2001 Feb;94(2):139-43.
The authors report two cases of stenosis of the superior caval canal after Mustard and Senning procedures for transposition of the great arteries in patients paced for atrial arrhythmia. During cardiac catheterisation, it was possible to treat the stenosis by perforation in one case and by balloon dilatation in the second, followed by the implantation of two stents to reestablish vascular patency. In one patient, two pacing catheters were implanted by an endovascular approach without complications three months after stenting; in the other case, epicardial pacing was required because the patient's condition could not wait for endothelialisation of the stent before implanting the pacing catheters. This technique of revascularisation may also be used in children with venous stenosis after implantation of endocavitary pacing catheters, in which the pacing system has to be changed.
作者报告了两例在Mustard和Senning手术治疗大动脉转位后，因房性心律失常而接受起搏治疗的患者出现上腔静脉狭窄的病例。在心脏导管插入术中，一例通过穿孔治疗狭窄，另一例通过球囊扩张治疗狭窄，随后植入两个支架以重建血管通畅。一名患者在支架置入三个月后通过血管内途径植入两根起搏导管，未出现并发症；另一例患者由于病情不允许在植入起搏导管前等待支架内皮化，因此需要进行心外膜起搏。这种血管重建技术也可用于植入心腔内起搏导管后出现静脉狭窄且需要更换起搏系统的儿童患者。
