Karagöz Tevfik, Akın Alper, Aykan Hayrettin Hakan, Çeliker Alpay, Alehan Dursun, Özer Sema, Özkutlu Süheyla
Division of Pediatric Cardiology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Turk J Pediatr. 2015 Mar-Apr;57(2):136-40.
The aim of our study was to share our clinical experience regarding cases of interventional cardiac catheterization in low-weight infants. We retrospectively reviewed all interventional catheterizations performed in infants weighing 2500 g or less between March 2001 and October 2012. Twenty patients were included in the study. The procedures included balloon atrial septostomy in 8 patients, balloon pulmonary valvuloplasty in 7 patients, balloon aortic valvuloplasty in 3 patients and balloon angioplasty for coarctation in 2 patients. The mean age at catheterization was 11.9 ± 9.6 days (range, 1 to 31 days) and the mean weight, 2038 ± 480 g (range, 1100 to 2500 g). The mean procedure time was 80.3 ± 32 minutes, and the mean fluoroscopy time was 17.5 ± 12 minutes. Only two patients had no benefit from the intervention. One patient died at day 4 after catheterization, due to sepsis. Complications occurred in 3 patients: one patient developed atrial flutter and respiratory arrest, one patient developed apnea episodes, and one patient developed anemia that required transfusion. In conclusion, although studies investigating complications related to invasive cardiac catheterization in infants weighing less than 2500 g have reported increased complication rates, such complications were less likely to result in permanent sequelae. We did not observe significant complications related to the procedure; therefore, we would like to suggest that invasive cardiac catheterization can appropriately be performed in low-weight infants.
我们研究的目的是分享我们在低体重婴儿介入性心导管插入术病例方面的临床经验。我们回顾性分析了2001年3月至2012年10月期间对体重2500克及以下婴儿进行的所有介入性导管插入术。该研究纳入了20名患者。手术包括8例球囊房间隔造口术、7例球囊肺动脉瓣成形术、3例球囊主动脉瓣成形术和2例动脉导管未闭球囊血管成形术。导管插入术时的平均年龄为11.9±9.6天(范围1至31天),平均体重为2038±480克(范围1100至2500克)。平均手术时间为80.3±32分钟,平均透视时间为17.5±12分钟。只有两名患者未从干预中获益。一名患者在导管插入术后第4天因败血症死亡。3例出现并发症:1例发生心房扑动和呼吸骤停,1例出现呼吸暂停发作,1例出现贫血需要输血。总之,尽管有关体重不足2500克婴儿侵入性心导管插入术相关并发症的研究报告并发症发生率增加,但此类并发症不太可能导致永久性后遗症。我们未观察到与该手术相关的重大并发症;因此,我们建议对低体重婴儿可适当进行侵入性心导管插入术。