Lombardi M, Tagliente M R, Pirolo T, Massari E, Sisto M, Vairo U
Department of Pediatric Cardiology, Ospedale Pediatrico Giovanni XXIII, Bari, Italy.
J Cardiovasc Med (Hagerstown). 2016 Dec;17 Suppl 2:e221-e223. doi: 10.2459/JCM.0000000000000197.
: The usual surgical practice after repair of a Total Anomalous Pulmonary Venous Connection (TAPVC) is to ligate the vertical vein (VV). Many surgeons find it expedient to leave the VV unligated to reduce pulmonary arterial pressure, decrease perioperative pulmonary hypertensive crisis, provide better hemodynamics postoperatively (1), and enable the adaptation of cardiac chambers to a new workload. Afterwards, the unligated VV may cause significant left-to-right shunt, likewise an atrial septal defect, mandating later surgical ligation or device closure (2). This report details transcatheter occlusion of a patent VV using a device Amplatzer Vascular Plug II, after TAPVC repair in early infancy. The transcatheter occlusion of an unligated VV after repair of supracardiac TAPVC represents an effective alternative to surgical redo. The device Amplatzer Vascular Plug II achieves great results.
完全性肺静脉异位连接(TAPVC)修复术后的常规外科手术操作是结扎垂直静脉(VV)。许多外科医生发现不结扎VV较为方便,以降低肺动脉压、减少围手术期肺动脉高压危象、在术后提供更好的血流动力学(1),并使心腔适应新的工作负荷。之后,未结扎的VV可能会导致明显的左向右分流,同样会导致房间隔缺损,这就需要后期进行外科结扎或封堵器闭合(2)。本报告详细介绍了在婴儿早期TAPVC修复术后,使用Amplatzer血管封堵器II对未闭的VV进行经导管封堵。心上型TAPVC修复术后未结扎VV的经导管封堵是再次手术的一种有效替代方法。Amplatzer血管封堵器II取得了很好的效果。