Rush Center for Congenital and Structural Heart Disease, Rush University Medical Center, Chicago, Illinois, USA.
J Interv Cardiol. 2011 Aug;24(4):373-7. doi: 10.1111/j.1540-8183.2011.00638.x. Epub 2011 Mar 17.
We describe our medium-term outcomes for peripheral pulmonary artery stenting in adults with congenital heart disease.
Improved outcomes in congenital heart disease have lead to the evolution of transcatheter therapies in adults aimed at maintaining normal hemodynamics. Stenting for pulmonary artery narrowing is effective in children, however little is known about outcomes in adults.
Retrospective data analysis and follow-up review of our complete experience with peripheral pulmonary artery stenting in adults.
Over a 9-year period we carried out 15 procedures, implanting 23 stents (11-left pulmonary artery) in the pulmonary arteries of 12 adult patients (7 female). Eleven patients had previous cardiac surgery. Median age at implantation was 32.5 years (range, 18.7-56.7 years) with median weight of 71.3 kg (range, 44.5-95 kg). Six patients underwent bilateral pulmonary artery stenting. Median procedure time was 140 minutes (range, 76-263 minutes) and 4 patients had other interventions performed during the same procedure. Median systolic pressure gradient across the narrowing's of 24 mmHg (range, 11-61 mmHg) was reduced to 3 mmHg (range, 0-17 mmHg) postprocedure (P < 0.001). Three patients had acute stent embolization, one of whom required surgical removal. No aneurysm formation or significant stent fractures have been noted on median follow-up of 27.4 months (range, 1-97 months). Two patients required reintervention with further stent implantation.
Pulmonary artery stenting provides effective relief of narrowing in adults with congenital heart disease. Bilateral and/or multiple stenting are often required. Stent embolization may occur particularly in patients with associated significant pulmonary regurgitation. (J Interven Cardiol 2011;24:373-377).
我们描述了成人先天性心脏病外周肺动脉支架置入术的中期结果。
先天性心脏病患者的治疗效果改善，促使针对成人患者的维持正常血液动力学的经导管治疗方法不断发展。肺动脉支架置入术在儿童中是有效的，但成人患者的相关结果知之甚少。
回顾性数据分析及对我们在成人中进行的外周肺动脉支架置入术完整经验的随访。
在 9 年期间，我们对 12 例成人患者（7 例女性）的肺动脉进行了 15 次手术，共植入 23 个支架（11 个左肺动脉）。11 例患者曾接受过心脏手术。支架置入时的中位年龄为 32.5 岁（范围 18.7-56.7 岁），中位体重为 71.3kg（范围 44.5-95kg）。6 例患者行双侧肺动脉支架置入。中位手术时间为 140 分钟（范围 76-263 分钟），4 例患者在同一手术中同时进行了其他介入操作。中位跨狭窄收缩压梯度从 24mmHg（范围 11-61mmHg）降低至术后 3mmHg（范围 0-17mmHg）（P＜0.001）。3 例患者出现急性支架栓塞，其中 1 例需要手术取出。在中位随访 27.4 个月（范围 1-97 个月）期间，未发现动脉瘤形成或明显的支架断裂。2 例患者需要再次介入治疗，植入进一步的支架。
肺动脉支架置入术可为成人先天性心脏病患者提供有效的狭窄缓解。通常需要双侧和/或多个支架。支架栓塞可能发生在伴有严重肺动脉瓣反流的患者中。（J 介入心脏病学 2011；24:373-377）。
