Department of Pediatric Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510100, China.
Chin Med J (Engl). 2017 Aug 20;130(16):1919-1925. doi: 10.4103/0366-6999.211894.
Transcatheter closure of congenital coronary artery fistulas (CCAFs) is an alternative therapy to surgery; however, data regarding transcatheter closure for CCAF with a giant coronary artery aneurysm (CAA) in pediatric patients are still limited due to the rarity of the disease. We aimed to evaluate the efficacy and safety of transcatheter closure for CCAF with a giant CAA in a pediatric population at a single center.
Medical records of pediatric patients (<18 years old) who underwent transcatheter closure of CCAF with a giant CAA between April 2007 and September 2016 at Guangdong Cardiovascular Institute (Guangdong, China) were reviewed.
Twelve patients (median age, 6.1 years; range, 1.9-11.0 years) underwent successful transcatheter closure procedures. One patient underwent closure at both the entry and exit points of the CAA, three patients underwent closure at the exit point of the CAA, and eight patients underwent closure at the entry point of the CAA. After a mean follow-up of 7.2 years (range, 0.5-9.8 years), one patient (with closure at the exit point of the CAA) underwent transcatheter re-intervention because of a significant residual shunt. She eventually underwent a surgical procedure due to aneurysm dilation after the second intervention. One patient experienced thrombus formation within the CAA after the procedure. Among those with closure at the entry point of the CAA, a mild-to-moderate residual shunt was detected in three patients.
Transcatheter closure appears to be a safe and effective alternative therapy for CCAF with a giant CAA in the pediatric population. Closure at the entry point of the CAA, and closure at both the entry and exit points when feasible, may reduce the risk of postinterventional complications.
经导管封堵术已成为先天性冠状动脉瘘（CCAF）的一种替代疗法；然而，由于该病罕见，儿科患者巨大冠状动脉瘤（CAA）相关 CCAF 的经导管封堵术的数据仍然有限。我们旨在评估单中心经导管封堵术治疗儿科患者 CCAF 合并巨大 CAA 的疗效和安全性。
回顾 2007 年 4 月至 2016 年 9 月期间在广东心血管病研究所（广东，中国）接受 CCAF 合并巨大 CAA 经导管封堵术的儿科患者（<18 岁）的病历记录。
12 例患者（中位年龄 6.1 岁；范围，1.9-11.0 岁）成功接受了经导管封堵术。1 例患者在 CAA 的入口和出口处均进行了封堵，3 例患者在 CAA 的出口处进行了封堵，8 例患者在 CAA 的入口处进行了封堵。平均随访 7.2 年（范围，0.5-9.8 年）后，1 例（在 CAA 出口处进行封堵）患者因明显残余分流而行经导管再介入治疗。由于第二次介入治疗后动脉瘤扩张，她最终接受了手术治疗。1 例患者在术后 CAA 内形成血栓。在 CAA 入口处封堵的患者中，3 例患者发现轻度至中度残余分流。
经导管封堵术似乎是儿科患者 CCAF 合并巨大 CAA 的一种安全有效的替代疗法。在可行的情况下，封堵 CAA 的入口和入口及出口均封堵，可能会降低介入后并发症的风险。
Zotero 插件
