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支架置入术在 Turner 综合征合并主动脉缩窄患者中的应用价值。

Usefulness of stenting in aortic coarctation in patients with the Turner syndrome.

机构信息

Department of Pediatrics, Children's Medical Center, Tehran University of Medical Sciences, Iran.

出版信息

Am J Cardiol. 2010 Nov 1;106(9):1327-31. doi: 10.1016/j.amjcard.2010.06.063.

Abstract

We report our experience with stent implantation for treatment of aortic coarctation in patients with Turner syndrome. Ten consecutive patients with Turner syndrome and aortic coarctation (median age 12 years, range 9 to 24) underwent coarctation stenting. Of these, 6 patients were treated for isolated coarctation and 4 for recurrent coarctation (3 after balloon dilation and 1 after balloon dilation and surgical repair). Bare metal stents were implanted in 7 patients and covered stents in 3. Immediately after stent implantation, peak systolic gradient decreased from 46.1 ± 24.3 to 1.9 ± 2.1 mm Hg (p <0.001). Aortic diameter at coarctation site increased from 5.1 ± 3.2 to 15.3 ± 2.0 mm after stenting (p <0.001). There were no deaths or procedure-related complications. During a median follow-up of 30.5 months, no patient developed restenosis. Two patients developed late aortic aneurysms at the coarctation site. In conclusion, stent implantation for aortic coarctation in patients with Turner syndrome appears to be a safe and effective alternative to surgical repair. Larger cohorts and longer-term follow-up are required to determine the effects of the procedure on the aortic wall.

摘要

我们报告了我们在 Turner 综合征患者中使用支架植入治疗主动脉缩窄的经验。10 例连续的 Turner 综合征合并主动脉缩窄患者(中位年龄 12 岁,范围 9 至 24 岁)接受了缩窄支架植入术。其中 6 例为单纯性缩窄,4 例为复发性缩窄(3 例为球囊扩张后,1 例为球囊扩张和手术修复后)。7 例患者植入裸金属支架,3 例患者植入覆膜支架。支架植入后即刻,收缩期峰值梯度从 46.1 ± 24.3 降至 1.9 ± 2.1 mm Hg(p <0.001)。支架植入后,缩窄部位的主动脉直径从 5.1 ± 3.2 增至 15.3 ± 2.0 mm(p <0.001)。无死亡或与手术相关的并发症。中位随访 30.5 个月期间,无患者发生再狭窄。2 例患者在缩窄部位出现迟发性主动脉瘤。总之,支架植入术治疗 Turner 综合征患者的主动脉缩窄似乎是一种安全有效的手术修复替代方法。需要更大的队列和更长时间的随访来确定该手术对主动脉壁的影响。

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