Zhou Yong, Guo Zhifu, Bai Yuan, Zhao Xianxian, Qin Yongwen, Chen Shaoping, Wu Hong, Huang Xinmiao, Li Songhua, Liu Bo
Department of Cardiology, No.411 Hospital of PLA, Shanghai, China; Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Congenit Heart Dis. 2014 Mar-Apr;9(2):122-5. doi: 10.1111/chd.12098. Epub 2013 May 20.
Structural heart interventions require the use of relatively large-diameter delivery sheaths or latex nylon net balloon catheters, which results in a relatively large-diameter venous puncture point. At present, femoral venous hemostasis is achieved by manual compression. A temporary figure-of-eight subcutaneous suture has been introduced to achieve immediate postprocedural femoral venous hemostasis after using a ≥24Fr sheath in an adult. This method is not well evaluated in children.
We report our experience using this technique in children treated with 7-14Fr sheaths. From May 2009 to March 2012, 104 children (ages ranging from 3 to 10 years, mean 8.1 ± 1.6 years) with atrial septal defects (n = 86) and pulmonary valve stenosis (n = 18) underwent percutaneous transcatheter interventions. Sheath sizes used were ≥7Fr (7Fr, n = 5; 8Fr, n = 29; 9Fr, n = 14; 10Fr, n = 15; 12Fr, n = 19; 14Fr, n = 22).
A total of 102 patients had immediate femoral vein hemostasis, and 2 developed a femoral vein hematoma requiring manual compression. One patient was diagnosed with a femoral artery pseudoaneurysm during hospitalization. On follow-up, there was no evidence of hematoma or thrombosis.
The "figure-of-eight" suture technique is effective and safe, achieving immediate hemostasis after the use of large femoral vein sheaths in children.
结构性心脏介入治疗需要使用相对大直径的输送鞘管或乳胶尼龙网囊导管，这会导致静脉穿刺点直径相对较大。目前，股静脉止血通过手动压迫实现。一种临时的“8”字形皮下缝合已被引入，用于在成人使用≥24Fr鞘管后立即实现术后股静脉止血。该方法在儿童中尚未得到充分评估。
我们报告了在使用7 - 14Fr鞘管治疗的儿童中使用该技术的经验。2009年5月至2012年3月，104名儿童（年龄3至10岁，平均8.1±1.6岁）患有房间隔缺损（n = 86）和肺动脉瓣狭窄（n = 18），接受了经皮导管介入治疗。使用的鞘管尺寸为≥7Fr（7Fr，n = 5；8Fr，n = 29；9Fr，n = 14；10Fr，n = 15；12Fr，n = 19；14Fr，n = 22）。
共有102例患者股静脉立即止血，2例出现股静脉血肿，需要手动压迫。1例患者在住院期间被诊断为股动脉假性动脉瘤。随访时，没有血肿或血栓形成的证据。
“8”字形缝合技术有效且安全，在儿童使用大直径股静脉鞘管后可实现立即止血。
