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[室间隔完整的肺动脉闭锁患儿经球囊血管成形术治疗多发性肺动脉狭窄后完成Fontan手术;病例报告]

[Fontan completion after balloon angioplasty of multiple pulmonary artery stenosis in a child with pulmonary atresia with intact ventricular septum; report of a case].

作者信息

Murakami Tomoaki, Ueno M, Takeda A, Yakuwa S, Yamazawa H, Murashita T, Imamura M, Konishi T

机构信息

Department of Pediatrics, Hokkaido University, Graduate School of Medicine, Sapporo, Japan.

出版信息

Kyobu Geka. 2006 Feb;59(2):157-9.

Abstract

A 5-year-old boy was referred to our institute for cardiac evaluation having been previously seen at another center. He had been diagnosed a pulmonary atresia with intact ventricular septum just after birth, and undergone Blalock-Taussig shunts. Although his central pulmonary artery pressure was high (mean pressure 26 mmHg) after bilateral Blalock-Taussig shunts, multiple peripheral pulmonary artery stenosis protected his pulmonary vascular bed from pressure load. We released the multiple pulmonary artery stenosis partly by catheter intervention and partly by surgical operation, and staged Fontan operation was completed. The surgery in combination with catheter therapies would expand the indication of Fontan-type operation, and it would contribute to the patients' postoperative prognosis.

摘要

一名5岁男孩此前在另一家中心就诊后,被转诊至我院进行心脏评估。他出生后即被诊断为室间隔完整的肺动脉闭锁,并接受了布莱洛克-陶西格分流术。尽管双侧布莱洛克-陶西格分流术后他的中心肺动脉压较高(平均压26 mmHg),但多处外周肺动脉狭窄保护了他的肺血管床免受压力负荷。我们通过导管介入和手术部分解除了多处肺动脉狭窄,并完成了分期Fontan手术。手术与导管治疗相结合将扩大Fontan型手术的适应证,并有助于改善患者的术后预后。

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