Petko Colin, Gray Robert G, Cowley Collin G
Division of Pediatric Cardiology, University of Utah, Primary Children's Medical Center, Salt Lake City, Utah 84113, USA.
Catheter Cardiovasc Interv. 2009 Jan 1;73(1):105-8. doi: 10.1002/ccd.21831.
Children with complex congenital heart disease often require staged palliation to regulate systemic and pulmonary blood flow. Accessory sources of pulmonary blood flow including aortopulmonary collaterals, aortopulmonary shunts, and ventriculopulmonary connections following Glenn or Fontan palliation can be associated with elevated central venous pressures and persistent pleural drainage. Occlusion of accessory ventriculopulmonary connections in this setting has traditionally been accomplished surgically.
To review the efficacy of Amplatzer devices in transcatheter occlusion of accessory ventriculopulmonary connections in children with complex congenital heart disease.
Patients were identified and their records retrospectively reviewed for indication, procedural details, and clinical efficacy and outcome.
Between December 2004 and March 2008, seven patients underwent occlusion of accessory ventriculopulmonary connections using an Amplatzer Septal Occluder (3), an Amplatzer Duct Occluder (3), or an Amplatzer Vascular Plug (1). Underlying single ventricle physiology was present in six of these patients. The site of occlusion was the right ventricle to pulmonary artery (Sano) conduit in two patients, the native main pulmonary artery in three patients, the pulmonary valve in one patient, and a left ventricle to pulmonary artery homograft in one patient with biventricular physiology. There were no complications associated with these procedures.
Amplatzer occlusion devices provide a safe and effective means of eliminating accessory ventriculopulmonary connections in children who have undergone surgical palliation of congenital heart disease.
患有复杂先天性心脏病的儿童通常需要分期姑息治疗来调节体循环和肺循环血流。肺血流的辅助来源，包括主动脉-肺动脉侧支、主动脉-肺动脉分流以及在格林或Fontan姑息治疗后出现的心室-肺动脉连接，可能与中心静脉压升高和持续性胸腔引流有关。在这种情况下，传统上通过手术来闭塞辅助性心室-肺动脉连接。
回顾Amplatzer装置经导管闭塞复杂先天性心脏病儿童辅助性心室-肺动脉连接的疗效。
确定患者并回顾其记录，以了解适应证、手术细节以及临床疗效和结果。
在2004年12月至2008年3月期间，7例患者使用Amplatzer房间隔封堵器（3例）、Amplatzer动脉导管封堵器（3例）或Amplatzer血管塞（1例）闭塞辅助性心室-肺动脉连接。其中6例患者存在潜在的单心室生理状态。闭塞部位在2例患者为右心室至肺动脉（Sano）管道，3例患者为天然主肺动脉，1例患者为肺动脉瓣，1例具有双心室生理状态的患者为左心室至肺动脉同种异体移植物。这些手术均无并发症。
Amplatzer封堵装置为消除接受先天性心脏病手术姑息治疗儿童的辅助性心室-肺动脉连接提供了一种安全有效的方法。
