Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Pediatric Cardiology, Little Rock, Arkansas 72202, USA.
Catheter Cardiovasc Interv. 2011 Feb 15;77(3):395-9. doi: 10.1002/ccd.22797. Epub 2010 Nov 3.
Our objective was to examine long-term outcomes of intraoperative pulmonary artery stents and determine risk factors for reintervention
Short-term outcomes of intraoperative pulmonary artery stents have been reported previously. However, long-term results are unknown.
We conducted a retrospective review of patients who underwent intraoperative pulmonary artery stent placement for branch pulmonary artery stenosis.
Ninety-six stents were implanted intraoperatively in 67 patients. Twenty-seven patients received two or more stents at initial intervention. Median patient age at initial stent placement was 1.8 years. Median post-inflation diameter was 8 mm. At a mean follow-up of 7.6±4.5 years, 49% of stents required reintervention (balloon angioplasty at catheterization in 28 patients and surgical revision in 19 patients). Actuarial freedom from reintervention at 2, 5, and 10 years was 68%, 49%, and 40%, respectively. In univariate analysis of time to first reintervention, age at implantation<2 yrs (P<0.0009) and initial post-inflation stent diameter<10 mm (P<0.0002) were associated with risk for reintervention. Multivariable Cox regression analysis showed age<2 years (P<0.005) and diagnosis of tetralogy of Fallot (p<0.002) or truncus arteriosus (P<0.007) to be significant risk factors for reintervention.
Intraoperative placement of stents in the pulmonary arteries is an alternative to surgical angioplasty, but is associated with a high incidence of reintervention. Age<2 years and the diagnosis of tetralogy of Fallot or truncus arteriosus are risk factors for reintervention.
我们的目的是研究术中肺动脉支架的长期结果，并确定再次介入的风险因素。
先前已经报道了术中肺动脉支架的短期结果。然而，长期结果尚不清楚。
我们对接受术中肺动脉支架置入术治疗肺叶动脉狭窄的患者进行了回顾性研究。
67 例患者共植入 96 个支架。27 例患者在初次介入时接受了两个或更多支架。初次支架置入时患者的中位年龄为 1.8 岁。中位后扩张直径为 8 毫米。平均随访 7.6±4.5 年后，49%的支架需要再次介入（28 例患者行球囊血管成形术，19 例患者行手术修复）。2、5 和 10 年的无再介入生存率分别为 68%、49%和 40%。在首次再介入时间的单因素分析中，植入时年龄<2 岁（P<0.0009）和初始后扩张支架直径<10 毫米（P<0.0002）与再介入风险相关。多变量 Cox 回归分析显示，年龄<2 岁（P<0.005）和诊断为法洛四联症（p<0.002）或动脉干畸形（P<0.007）是再介入的显著危险因素。
术中肺动脉支架置入术是一种替代外科血管成形术的方法，但再介入的发生率较高。年龄<2 岁和法洛四联症或动脉干畸形的诊断是再介入的危险因素。
