Dedeoglu Reyhan, Saltık Levent, Atik Sezen Ugan, Eroglu Ayşe Güler
Department of Pediatric Cardiology, Istanbul University, Cerrahpaşa Medical Faculty, Istanbul, Turkey.
Prof., Department of Pediatric Cardiology, Istanbul University, Cerrahpaşa Medical Faculty, Istanbul, Turkey.
Indian Heart J. 2016 Sep;68 Suppl 2(Suppl 2):S233-S236. doi: 10.1016/j.ihj.2016.03.010. Epub 2016 Apr 15.
For a newborn, surgical correction has been the primary treatment of native coarctation at most centers; however, there has been an increased use of balloon angioplasty (BA). The anterograde transvenous (AT) technique is another alternative way for coarctation (AoC) angioplasty in low weight patients with large ventricular septal defect (VSD). Four, 5-day-old to 7-month-old, infants weighing 2500, 2700, 2800, and 3400g, respectively presented to emergency unit (EU) with cyanosis, tachypnea, and loss of weight. Echocardiography demonstrated AoC and VSD. All four children were admitted to the EU with hemodynamic compromise and critically ill status. We used femoral vein for sheath and used VSD to enter left ventricle from right antegrade route, and performed BA without any complication. AT described in this report is another alternative way for coarctation angioplasty in patients with large VSD. We suggest that AT BA can be applied to small infants in situations where surgery might have been hazardous.
对于新生儿,在大多数中心,外科矫正一直是原发性主动脉缩窄的主要治疗方法;然而,球囊血管成形术(BA)的使用有所增加。顺行经静脉(AT)技术是体重低且患有大型室间隔缺损(VSD)的患者进行主动脉缩窄(AoC)血管成形术的另一种替代方法。四名分别为5日龄至7月龄、体重分别为2500g、2700g、2800g和3400g的婴儿因发绀、呼吸急促和体重减轻被送至急诊室(EU)。超声心动图显示存在主动脉缩窄和室间隔缺损。所有四名儿童因血流动力学不稳定和危重状态被收治入急诊室。我们通过股静脉置入鞘管,经室间隔缺损从右向左顺行进入左心室,并进行了球囊血管成形术,未出现任何并发症。本报告中描述的顺行经静脉球囊血管成形术是大型室间隔缺损患者主动脉缩窄血管成形术的另一种替代方法。我们建议,在手术可能具有危险性的情况下,顺行经静脉球囊血管成形术可应用于小婴儿。