Division of Pediatric Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA.
World J Pediatr Congenit Heart Surg. 2020 Jul;11(4):NP164-NP167. doi: 10.1177/2150135118782191. Epub 2018 Aug 22.
Obstructed total anomalous pulmonary venous connection (TAPVC) involves anomalous drainage of all pulmonary veins to a location other than the left atrium and typically causes significant respiratory symptoms requiring urgent surgical repair. Premature infants born with obstructed TAPVC are often not considered to be suitable surgical candidates due to their size and therefore pose a significant treatment dilemma. Catheter-based interventions provide a temporizing option for infants with obstructed TAPVC, allowing for hemodynamic stabilization and growth until surgical intervention is feasible. We describe the course of two premature infants with obstructed TAPVC who were palliated with stenting of their anomalous pulmonary veins. Both infants required repeat catheter-based intervention for recurrent stenosis and ultimately underwent successful surgical repair at an acceptable weight and corrected gestational age. We propose that a novel catheter-based approach to initial management may be a beneficial option in the premature and low-weight patient population.
完全性肺静脉异位引流（TAPVC）是指所有肺静脉异常引流至左心房以外的部位，通常会导致严重的呼吸系统症状，需要紧急手术修复。患有完全性 TAPVC 的早产儿通常由于体型较小而不被认为是适合手术的候选者，因此存在重大的治疗难题。基于导管的介入治疗为患有完全性 TAPVC 的婴儿提供了一种临时选择，可实现血液动力学稳定和生长，直到手术干预可行。我们描述了两名患有完全性 TAPVC 的早产儿的病程，他们通过对异常肺静脉进行支架置入术进行姑息治疗。两名婴儿均因狭窄复发而需要重复进行基于导管的介入治疗，最终在可接受的体重和校正胎龄时成功进行了手术修复。我们提出，对于早产儿和低体重患者群体，一种新颖的基于导管的初始治疗方法可能是一种有益的选择。
