Madan Nitin, Ellozy Sharif, Love Barry
Department of Pediatric Cardiology, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1201, New York, NY 10029, USA.
J Invasive Cardiol. 2012 Feb;24(2):E32-4.
Patients with Fontan baffles for single ventricle may have cyanosis from right-to-left shunt through leaks in the baffle or due to intentionally created fenestrations. Typically this right-to-left shunt may be addressed with catheter-based occlusion devices. However, in narrowing of the Fontan baffle, placement of occluders within the Fontan baffle may additionally narrow the pathway and is therefore undesirable. We describe 2 patients with the combination of Fontan baffle stenosis and patent fenestration treated with a Zenith abdominal aortic aneurysm endograft (Cook Medical). The covered stent graft both occluded the right-to-left shunt and eliminated the baffle stenosis. Both patients have had symptomatic improvement.
接受Fontan分流术治疗单心室的患者,可能会因分流板渗漏或故意制造的开窗导致右向左分流而出现紫绀。通常,这种右向左分流可用基于导管的封堵装置处理。然而,在Fontan分流板狭窄的情况下,在Fontan分流板内放置封堵器可能会进一步缩窄通路,因此不可取。我们描述了2例接受Zenith腹主动脉瘤腔内修复装置(库克医疗公司)治疗的Fontan分流板狭窄合并开窗未闭的患者。带膜支架移植物既封堵了右向左分流,又消除了分流板狭窄。两名患者的症状均有改善。