Patel Hitendra T, Hijazi Ziyad M
Children's Hospital and Research Center at Oakland, Oakland, California, USA.
Curr Opin Pediatr. 2005 Oct;17(5):568-73. doi: 10.1097/01.mop.0000172813.56766.52.
The fields of pediatric and congenital cardiac interventions continue to expand at a rapid pace. The last few years have witnessed a tremendous explosion in procedures such as the transcatheter closure of secundum atrial septal defects, patent foramen ovale, patent ductus arteriosus, stent placement for pulmonary artery stenosis, and coarctation of the aorta. The purpose of this review is to highlight important publications in the last year and the direction the field is taking.
Research data over the last year has concentrated on six main themes: (a) mid-to-long-term data for device closure of atrial septal defects, the incidence of late cardiac erosions, thrombus formation and heart block; (b) the transcatheter closure of muscular ventricular septal defects; (c) the transcatheter closure of perimembranous ventricular septal defects; (d) the placement of bioprosthetic valves in the pulmonary and aortic positions; (e) the 'hybrid' approach that combines surgical and interventional techniques in the management of various congenital cardiac defects; and (f) fetal interventions.
This review outlines the key data presented in the literature involving interventional cardiology for pediatric and congenital cardiac defects over the last year. It illustrates that in close collaboration with industry, together with bioengineers and cardiothoracic surgeons, adult cardiac interventionists and perinatologists should continue to expand the role of pediatric catheter interventions. Fetal interventions have the potential to alter the natural history of abnormal cardiac development.
小儿及先天性心脏介入领域持续快速发展。过去几年见证了诸如继发孔型房间隔缺损、卵圆孔未闭、动脉导管未闭、肺动脉狭窄支架置入及主动脉缩窄等介入手术的巨大突破。本综述旨在突出过去一年的重要出版物以及该领域的发展方向。
过去一年的研究数据集中在六个主要主题:(a)房间隔缺损封堵装置的中长期数据、晚期心脏侵蚀、血栓形成及心脏传导阻滞的发生率;(b)肌部室间隔缺损的经导管封堵;(c)膜周部室间隔缺损的经导管封堵;(d)肺动脉及主动脉位置生物瓣膜的置入;(e)在各种先天性心脏缺陷管理中结合手术和介入技术的“杂交”方法;(f)胎儿介入。
本综述概述了过去一年文献中有关小儿及先天性心脏缺陷介入心脏病学的关键数据。表明与行业、生物工程师及心胸外科医生密切合作,成人心脏介入医生及围产医学专家应继续扩大小儿导管介入的作用。胎儿介入有可能改变心脏异常发育的自然病程。