Marx M, Huber W D, Crone J, Lammer J, Perneczky-Hintringer E, Heller S, Schlemmer M, Salzer-Muhar U
Department of Paediatrics, University of Vienna, Austria.
Eur J Pediatr. 2001 Aug;160(8):501-4. doi: 10.1007/s004310100770.
We report on the rare case of a 4-year-old boy with patent ductus venosus and pulmonary hypertension presenting with progressive fatigue, tachypnoea at rest and tachycardia. Cardiac catheterisation revealed suprasystemic pressure in the pulmonary arteries with severely elevated pulmonary vascular resistance. In order to reduce the diameter of the ductus venosus, a stent was implanted interventionally, which closed, as expected, spontaneously 2 years later. Pulmonary arterial pressure and pulmonary vascular resistance decreased significantly and the general condition of the boy improved dramatically.
To the best of our knowledge, this represents the first report of successful interventional stent occlusion of a patent ductus venosus associated with severe pulmonary hypertension. The future will tell whether this intervention is curative or represents a bridging procedure for subsequent liver transplantation.
我们报告了一例罕见病例，一名4岁男孩患有静脉导管未闭和肺动脉高压，表现为进行性疲劳、静息时呼吸急促和心动过速。心导管检查显示肺动脉压力超过体循环压力，肺血管阻力严重升高。为了减小静脉导管的直径，通过介入方式植入了一个支架，如预期的那样，该支架在2年后自行闭合。肺动脉压力和肺血管阻力显著降低，男孩的总体状况明显改善。
据我们所知，这是首例成功通过介入性支架封堵与严重肺动脉高压相关的静脉导管未闭的报告。未来将揭示这种干预是治愈性的还是后续肝移植的桥接手术。
