Jeong Soo In, Huh June, Lee Heung Jae, Yang Ji Hyuk, Jun Tae Gook, Kang I Seok
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
Pediatr Cardiol. 2010 Jan;31(1):44-9. doi: 10.1007/s00246-009-9543-x. Epub 2009 Oct 15.
The objective of this study was to report the outcome of fenestration closure using either an Amplatzer Vascular Plug I or detachable coils in patients undergoing extracardiac Fontan procedure with conduit fenestration. We reviewed the medical records of 23 patients who underwent transcatheter closure of conduit fenestration with the extracardiac Fontan procedure. The median age at fenestration closure was 57 months (range 36 to 98). The median interval between the operation and the procedure was 28 months (range 8 to 68). The Amplatzer Vascular Plug I (AVP) was used in 16 patients, and detachable coils were used in 7 patients. In the coil group, we used 1 coil in 3 patients, 2 coils in patients, and 3 coils in 1 patient, all based on angiographic results. In the AVP group, we used a device that was at least 1 mm larger than the initial fenestration size. No immediate or long-term complications were associated with the procedure or with the closure devices. On final follow-up, 3 of 7 patients (43%) in the coil group had complete closure, and 17 of 17 patients (100%) in the AVP group had complete closure. The AVP showed good results for transcatheter closure of a conduit-type fenestration and was found to perform better than the detachable coil.
本研究的目的是报告在接受心外膜Fontan手术并带有管道开窗的患者中，使用Amplatzer血管封堵器I型或可脱卸线圈进行开窗闭合的结果。我们回顾了23例行心外膜Fontan手术经导管闭合管道开窗患者的病历。开窗闭合时的中位年龄为57个月（范围36至98个月）。手术与该操作之间的中位间隔时间为28个月（范围8至68个月）。16例患者使用了Amplatzer血管封堵器I型（AVP），7例患者使用了可脱卸线圈。在线圈组中，根据血管造影结果，3例患者使用1个线圈，部分患者使用2个线圈，1例患者使用3个线圈。在AVP组中，我们使用了比初始开窗尺寸至少大1 mm的装置。该操作或闭合装置均未引起即刻或长期并发症。在末次随访时，线圈组7例患者中有3例（43%）实现完全闭合，AVP组17例患者中有17例（100%）实现完全闭合。AVP在心外膜管道型开窗的经导管闭合中显示出良好效果，且发现其效果优于可脱卸线圈。
