Bautista-Rodriguez Carles, Rodriguez-Fanjul Javier, Moreno Hernando Julio, Mayol Javier, Caffarena-Calvar Jose Maria
1 Pediatric Cardiology Department, Hospital Sant Joan de Deu-Hospital Clínic, Universitat de Barcelona, Esplugues, Barcelona, Spain.
2 Neonatology Department, Hospital Sant Joan de Deu-Hospital Clínic, Universitat de Barcelona, Esplugues, Barcelona, Spain.
World J Pediatr Congenit Heart Surg. 2017 Sep;8(5):643-645. doi: 10.1177/2150135116655122. Epub 2016 Sep 19.
We report two cases of newborns with critical pulmonary stenosis having intact ventricular septum, who underwent pulmonary valve balloon valvuloplasty followed by banding of a patent ductus arteriosus. Transcatheter pulmonary valvuloplasty was performed one week after delivery. Following the procedure, both developed "circular shunting" as a consequence of left-to-right ductal flow and pulmonary regurgitation. This in turn caused increased blood flow into a dysfunctional right ventricle and low systemic cardiac output syndrome. The PDA banding was performed urgently as a rescue measure in order to restore systemic flow while still maintaining some duct-dependent pulmonary blood flow. This approach resolved the circular shunting. Outcome was favorable in both the patients.
我们报告两例患有严重肺动脉狭窄且室间隔完整的新生儿，他们接受了肺动脉瓣球囊瓣膜成形术，随后对动脉导管未闭进行了结扎。出生后一周进行了经导管肺动脉瓣成形术。术后，由于动脉导管左向右分流和肺动脉反流，两人均出现“环状分流”。这进而导致进入功能不全的右心室的血流增加和低心排血量综合征。紧急进行动脉导管未闭结扎作为一种挽救措施，以恢复体循环血流，同时仍维持一些依赖动脉导管的肺血流。这种方法解决了环状分流问题。两名患者的预后均良好。
