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Cheatham-Platinum 支架植入术治疗儿童和青少年肺动脉狭窄:即刻和中期结果。

Cheatham-Platinum stent implantation for pulmonary artery stenosis in children and adolescents: immediate and mid-term outcome.

机构信息

Department of Pediatrics, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, China.

出版信息

World J Pediatr. 2010 Nov;6(4):337-41. doi: 10.1007/s12519-010-0233-9. Epub 2010 Nov 16.

Abstract

BACKGROUND

NuMED Cheatham-Platinum (CP) stent implantation for pulmonary artery stenosis in children and adolescents has been rarely reported. This study aimed to evaluate the immediate and mid-term results of CP stent implantation for the treatment of pulmonary artery stenosis associated with congenital heart disease (CHD) in children and adolescents.

METHODS

From August 2005 to May 2007, four consecutive pediatric patients with pulmonary artery stenosis associated with CHD underwent CP stent implantation. They were followed up, and transthoracic echocardiography was done for outcome evaluation.

RESULTS

In the four patients, 5 stent placement procedures were performed and 7 CP stents were implanted (8-zig, 22-39 mm in length). All stents except one were successfully placed in the target lesions without displacement during the procedures. After the procedure, the systolic pressure gradient across the stenosis decreased from 36.67 ± 20.08 to 3.67 ± 3.20 mmHg (P=0.005), and the narrowest diameter of the stenotic segment increased from 6.97 ± 2.22 to 13.40 ± 4.40 mm (P=0.013). Two stents implanted in the left and right pulmonary arteries in patient 4 developed intrastent restenosis 6 months after the procedure, and the distal end of the main pulmonary artery also developed restenosis 26 months later. The results of the remaining stents have been stable without complications during a median follow-up of 34 months (range, 26-48 months).

CONCLUSIONS

Our experience indicates that CP stent implantation is suitable for the treatment of pulmonary artery stenosis in children and adolescents with CHD. The immediate and mid-term results are encouraging, but long-term results demand further follow-up in more cases.

摘要

背景

NuMED Cheatham-Platinum(CP)支架植入术治疗儿童和青少年肺动脉狭窄的应用鲜有报道。本研究旨在评估 CP 支架植入术治疗儿童和青少年先天性心脏病(CHD)相关肺动脉狭窄的即刻和中期结果。

方法

2005 年 8 月至 2007 年 5 月,4 例连续的 CHD 合并肺动脉狭窄患儿接受 CP 支架植入术。对其进行随访,并经胸超声心动图进行结果评估。

结果

4 例患者共进行了 5 次支架置入术,植入了 7 枚 CP 支架(8-zig,长 22-39mm)。除 1 例外,所有支架均成功放置于靶病变部位,术中无移位。术后,狭窄处收缩期压力梯度从 36.67±20.08mmHg 降至 3.67±3.20mmHg(P=0.005),狭窄节段最窄直径从 6.97±2.22mm 增至 13.40±4.40mm(P=0.013)。患者 4 的左、右肺动脉内植入的 2 枚支架术后 6 个月发生支架内再狭窄,主肺动脉远端 26 个月后也发生再狭窄。其余支架的结果在中位随访 34 个月(26-48 个月)期间一直稳定,无并发症。

结论

我们的经验表明 CP 支架植入术适合治疗 CHD 合并肺动脉狭窄的儿童和青少年。即刻和中期结果令人鼓舞,但长期结果需要更多病例的进一步随访。

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