Ergül Yakup, Nişli Kemal, Dindar Aygün, Eker Ömeroğlu Rukiye, Aydoğan Umrah
İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Çocuk Kardiyolojisi Bilim Dalı, İstanbul, Türkiye.
Anadolu Kardiyol Derg. 2011 Jun;11(4):336-42. doi: 10.5152/akd.2011.085. Epub 2011 May 11.
Pediatric patients with different age groups who underwent balloon angioplasty for aortic coarctation were evaluated for recoarctation, aneurysm, peripheral arterial injuries and concomitant diseases.
From January 1994 to 2010, 80 patients with aortic coarctation (native/recoarctation) were evaluated, retrospectively. According to age at angioplasty, patients were divided into three groups: Group A (0-3 months, n=29, 25 male/4 female, average weight 4±1.2 kg), Group B (3-12 months, n=20, 15 male/5 girls, average weight 6.5±1.9 kg) and Group C (> 1 year, n= 31, 15 male/16 girls, average weight 22.8±16 kg). The patients were followed with echocardiography and clinical signs. The data of the native and recoarcted patients and also those in three different age groups were analyzed by using Chi-square, Kruskal-Wallis, and Student t tests.
Peak systolic pressure gradient was reduced from 42±17 mmHg to 6.2±6 mmHg after balloon angioplasty (p<0.001) [n=80, 56 (70%) native, 24 (30%) recoarctation]. There was no difference between groups for early success. None of them did require immediate surgery. There were ventricular septal defect in 23 (28.7%), bicuspid aorta in 18 (22.5%), patent ductus arteriosus in 11 (13.7%) patients. Two patients had Turner's syndrome. Mean follow-up period was 74±56 months. While recoarctation developed in 20 (25%), [12 (60%) in Group A, 5 (25%) in Group B and 3 (15%) in group C, incidence was higher in the 0-3 months age group (p=0.018). Femoral artery occlusion and aneurysm were developed in 6 (7.5%) and 4 (5%) patients, respectively, and all of them were under 1-year-old.
Balloon angioplasty can be used a method in treatment of native aortic coarctation and postoperative restenosis. Especially, children under 3 months should be monitored closely after the procedure for recoarctation, aneurysms and peripheral artery problems.
对接受主动脉缩窄球囊血管成形术的不同年龄组儿科患者进行再缩窄、动脉瘤、外周动脉损伤及合并疾病的评估。
回顾性评估1994年1月至2010年期间80例主动脉缩窄（原发性/再缩窄）患者。根据血管成形术时的年龄，将患者分为三组：A组（0 - 3个月，n = 29，男25例/女4例，平均体重4±1.2 kg），B组（3 - 12个月，n = 20，男15例/女5例，平均体重6.5±1.9 kg）和C组（>1岁，n = 31，男15例/女16例，平均体重22.8±16 kg）。通过超声心动图和临床体征对患者进行随访。采用卡方检验、Kruskal - Wallis检验和Student t检验对原发性和再缩窄患者以及三个不同年龄组患者的数据进行分析。
球囊血管成形术后收缩压峰值梯度从42±17 mmHg降至6.2±6 mmHg（p<0.001）[n = 80，56例（70%）原发性，24例（30%）再缩窄]。各组早期成功率无差异。均无需立即手术。23例（28.7%）患者有室间隔缺损，18例（22.5%）患者有二叶式主动脉瓣，11例（13.7%）患者有动脉导管未闭。2例患者患有特纳综合征。平均随访期为74±56个月。20例（25%）发生再缩窄，[A组12例（60%），B组5例（25%），C组3例（15%），0 - 3个月年龄组发生率更高（p = 0.018）]。分别有6例（7.5%）和4例（5%）患者发生股动脉闭塞和动脉瘤，且均为1岁以下患者。
球囊血管成形术可作为原发性主动脉缩窄及术后再狭窄的治疗方法。特别是，3个月以下儿童术后应密切监测是否发生再缩窄、动脉瘤和外周动脉问题。
