Hwang M S, Su W J
Department of Paediatric Cardiology, Chang Gung Children's Hospital, Taoyuan, Taiwan.
Acta Paediatr. 2005 Mar;94(3):372-4. doi: 10.1111/j.1651-2227.2005.tb03083.x.
Two infants developed hoarseness unexpectedly the day after transcatheter coil closure of a slender patent ductus arteriosus (PDA). The pathogenesis of this complication appears to be similar to that of the classic cardiovocal syndrome. During the intervention, the inappropriately implanted coil might have distorted the slender PDA, thereby causing angulation of the pliable PDA itself and precipitating impingement on the left recurrent laryngeal nerve. Fortunately, both infants recovered spontaneously from the hoarseness within several weeks. At present, the definite underlying neuropathology of this complication is unknown as we have not yet confirmed recovery of the left vocal cord movement by follow-up fibreoptic bronchoscopy.
Iatrogenic cardiovocal syndrome could occur in infants after transcatheter coil closure of a slender PDA, using the currently popular 0.038-inch coil. A coil with a smaller diameter might prevent the occurrence of this syndrome.
两名婴儿在经导管线圈封堵细长型动脉导管未闭（PDA）后次日意外出现声音嘶哑。这种并发症的发病机制似乎与经典的心声综合征相似。在介入治疗过程中，植入不当的线圈可能使细长的PDA变形，从而导致柔软的PDA自身成角，并引发对左喉返神经的压迫。幸运的是，两名婴儿的声音嘶哑均在数周内自发恢复。目前，由于我们尚未通过后续的纤维支气管镜检查确认左声带运动是否恢复，因此该并发症确切的潜在神经病理学尚不清楚。
使用当前流行的0.038英寸线圈经导管线圈封堵细长型PDA后，婴儿可能发生医源性心声综合征。直径较小的线圈可能会预防该综合征的发生。
