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生长支架的早期和中期结果——一种通过支架植入对从婴儿期到成年期的主动脉缩窄进行经导管治疗的可能概念?

Early and mid-term results with the Growth Stent--a possible concept for transcatheter treatment of aortic coarctation from infancy to adulthood by stent implantation?

作者信息

Ewert Peter, Peters Bjoern, Nagdyman Nicole, Miera Oliver, Kühne Titus, Berger Felix

机构信息

Department for Congenital Heart Diseases/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Germany.

出版信息

Catheter Cardiovasc Interv. 2008 Jan 1;71(1):120-6. doi: 10.1002/ccd.21397.

Abstract

AIMS

Evaluation of the Growth Stent-a stent consisting of two stent halves connected by reabsorbable sutures-for the treatment of aortic coarctation in infants.

METHODS AND RESULTS

Surveillance study of 13 Growth Stents implanted in 12 patients aged 1-15 months (median 5 months). Body weight ranged from 3.4-12.8 kg (median 5.4 kg). Eight patients suffered from aortic (re-)coarctation, four of them from stenosis of the aortic anastomosis after a Norwood I procedure. The follow-up period was 24 months (11-51 months). Pressure gradients immediately after stent implantation decreased from 30 mm Hg (range 20-50 mm Hg) to 8 mm Hg (range 0-15 mm Hg). Five patients had one (3 pts) or two (2 pts) balloon dilations 3-28 months (median 12 months) after Growth Stent implantation. The median pressure gradient decreased from 25 mm Hg (range 15-30 mm Hg) to 15 mm Hg (range 5-25 mm Hg). Six patients received a large stent after 19-34 months. Median body weight was 11.8 kg (9.4-15 kg).

CONCLUSIONS

The Growth Stent is suitable for the acute treatment of aortic coarctation in infants and can be overstented later on--if necessary--with a larger stent without causing restriction.

摘要

目的

评估生长支架(一种由两半通过可吸收缝线连接的支架组成的支架)用于治疗婴儿主动脉缩窄的效果。

方法与结果

对12例年龄1至15个月(中位年龄5个月)的患者植入的13个生长支架进行监测研究。体重范围为3.4至12.8千克(中位体重5.4千克)。8例患者患有主动脉(再)缩窄,其中4例在诺伍德I手术后出现主动脉吻合口狭窄。随访期为24个月(11至51个月)。支架植入后即刻压力阶差从30毫米汞柱(范围20至50毫米汞柱)降至8毫米汞柱(范围0至15毫米汞柱)。5例患者在生长支架植入后3至28个月(中位时间12个月)进行了1次(3例)或2次(2例)球囊扩张。中位压力阶差从25毫米汞柱(范围15至30毫米汞柱)降至15毫米汞柱(范围5至25毫米汞柱)。6例患者在19至34个月后接受了大型支架植入。中位体重为11.8千克(9.4至15千克)。

结论

生长支架适用于婴儿主动脉缩窄的急性治疗,如有必要,后期可使用更大的支架进行再次支架植入,且不会造成限制。

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