Xiao Yun-Bin, Chen Zhi, Huang Xi-Yong, Wang Xiang, Wang Xun, Yang Zhou
Department of Cardiology, Hunan Provincial Children's Hospital, Changsha 410007, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2015 Apr;17(4):384-9.
To evaluate the short- and medium-term efficacy, complications, and anti-coagulation therapies related to transcatheter closure (TCC) of coronary artery fistula (CAF) in children.
We conducted a retrospective review of the medical records of 12 children with CAF who underwent TCC between January 2006 and January 2014, focusing on details such as preoperative, radiographic, and postoperative follow-up data, to record closure methods for CAF, anti-coagulation therapies, postoperative complications, and results of auxiliary examinations.
Among the 12 cases who underwent successful TCC and whose age was 1-158 months, four patients had proximal/medium-sized CAF, five had proximal/large CAF, and three had distal/medium-sized CAF. The mean period of postoperative follow-up was 3.5±2.4 years. Eleven patients took aspirin for 6 months post closure, and one took it for 18 months. Neither coronary thrombosis nor interventional complications were found. Left ventricular ejection fraction, cardiothoracic ratio, pulmonary artery pressure, and the diameters of coronary artery lesions decreased post TCC.
TCC is feasible and safe in proximal and distal/medium-sized CAF patients. Postoperative anti-coagulation with aspirin may prevent short- and medium-term thrombosis, but treatment course and safety need to be investigated by further follow-ups.
评估经导管封堵术(TCC)治疗儿童冠状动脉瘘(CAF)的短期和中期疗效、并发症及抗凝治疗情况。
我们对2006年1月至2014年1月期间接受TCC治疗的12例CAF患儿的病历进行了回顾性分析,重点关注术前、影像学及术后随访数据等细节,记录CAF的封堵方法、抗凝治疗、术后并发症及辅助检查结果。
12例TCC成功的患儿年龄为1至158个月,其中4例为近端/中等大小CAF,5例为近端/大CAF,3例为远端/中等大小CAF。术后平均随访时间为3.5±2.4年。11例患儿封堵术后服用阿司匹林6个月,1例服用18个月。未发现冠状动脉血栓形成及介入并发症。TCC术后左心室射血分数、心胸比、肺动脉压及冠状动脉病变直径均减小。
TCC治疗近端及远端/中等大小CAF患者可行且安全。术后应用阿司匹林抗凝可预防短期和中期血栓形成,但治疗疗程及安全性需通过进一步随访研究。