Presbitero P, Lisignoli V, Zavalloni D, Rossi M L, Gasparini G L, Belli G, Pagnotta P
Department of Invasive Cardiology, Istituto Clinico Humanitas Mirasole Spa, Milan, Italy.
Minerva Cardioangiol. 2007 Oct;55(5):669-79.
Over the last years, endovascular intervention have become an important part of treatment in patients with congenital heart disease particularly for residual defects after surgery done in infancy. These transcatheter procedures can be described as dilatation of stenotic sites (angioplasty, endovascular stenting and valvuloplasty) or as a closure of anomalous openings (device closure defects and vascular embolisation). Balloon valvuloplasty, without or with stent, is the procedure of choice in adults with pulmonary valve stenosis, pulmonary arteries stenosis, bicuspid aortic valve stenosis without calcification, aortic re-coarctation. Treatment of native aortic coarctation is still under debate. Devices for closing atrial and ventricular septal defects or patent ductus arteriosus have been developed and are now widely used. Transcatheter, plug or coil occlusion is nowadays the goal treatment in a wide range of arterial and venous vascular connections. This review describes the current role of each major catheter-directed therapy in the treatment of congenital heart disease in adults.
在过去几年中,血管内介入已成为先天性心脏病患者治疗的重要组成部分,尤其是对于婴儿期手术后的残余缺陷。这些经导管手术可描述为狭窄部位的扩张(血管成形术、血管内支架置入术和瓣膜成形术)或异常开口的闭合(器械封堵缺损和血管栓塞)。无论有无支架的球囊瓣膜成形术,都是成人肺动脉瓣狭窄、肺动脉狭窄、无钙化的二叶式主动脉瓣狭窄、主动脉再缩窄的首选治疗方法。对于原发性主动脉缩窄的治疗仍存在争议。用于闭合房间隔缺损、室间隔缺损或动脉导管未闭的器械已被开发出来,并且现在被广泛使用。经导管、封堵器或线圈封堵如今是广泛的动静脉血管连接的目标治疗方法。本综述描述了每种主要导管导向治疗在成人先天性心脏病治疗中的当前作用。