Márquez-González Horacio, López-Gallegos Diana, Pérez-Velázquez Nataly Alejandra, Yáñez-Gutiérrez Lucelli
Servicio de Cardiopatías Congénitas, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
Rev Med Inst Mex Seguro Soc. 2017;55 Suppl 1:S86-S91.
Left-sided cardiac obstructions represent 15% of congenital heart disease (CHD). The treatment in adults is surgical; however, balloon dilation by interventional catheterization can alleviate the symptoms in pediatric patients to allow them to reach the target height. The aim was to determine the survival and the factors associated with reintervention in patients with CHD with left-sided obstruction treated with balloon angioplasty.
A cohort study was conducted in patients aged 4 to 17 years with left-sided heart obstruction (valvular stenosis [VS], supravalvular aortic stenosis [SAS], coarctation of the aorta [CA]) successfully treated with balloon angioplasty. The follow-up was of 10 years and the outcome variable was the restenosis with reintervention criteria. Pediatric stage at the time of the procedure, nutritional status, residual gradient, and presence of genetic syndromes were considered prognostic variables. For statistical analysis, measures of central tendency and dispersion were used. Chi squared was employed in qualitative variables and Kruskal-Wallis in quantitative variables.
We had a total of 110 patients: 40% had CA, 35% VS, and 25% SAS. 39% required reintervention: 80% in SAS, 35% in CA, and 14% in VS.
The intervention balloon is a stopgap measure that allows patients with left-sided obstructions to reach the target height.
左侧心脏梗阻占先天性心脏病（CHD）的15%。成人的治疗方法是手术治疗；然而，介入导管球囊扩张术可缓解小儿患者的症状，使其达到目标身高。本研究旨在确定接受球囊血管成形术治疗的左侧梗阻性CHD患者的生存率及再次干预相关因素。
对4至17岁成功接受球囊血管成形术治疗左侧心脏梗阻（瓣膜狭窄[VS]、瓣上主动脉狭窄[SAS]、主动脉缩窄[CA]）的患者进行队列研究。随访10年，结局变量为符合再次干预标准的再狭窄情况。将手术时的小儿分期、营养状况、残余压差及遗传综合征的存在情况视为预后变量。统计分析采用集中趋势和离散度测量方法。定性变量采用卡方检验，定量变量采用Kruskal-Wallis检验。
共纳入110例患者：40%为CA，35%为VS，25%为SAS。39%的患者需要再次干预：SAS患者中80%需要再次干预，CA患者中35%需要再次干预，VS患者中14%需要再次干预。
介入球囊是一种权宜措施，可使左侧梗阻患者达到目标身高。
