Higaki Takashi, Yamamoto Eiichi, Nakano Takeshi, Ohta Masaaki, Takata Hidemi, Murao Kikuko, Chisaka Toshiyuki, Moritani Tomozo, Nagashima Mitsugi, Shikata Fumiaki, Ishii Eiichi
Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan.
Department of Pediatric Cardiology, Stroke & Cardiovascular Center, Ehime University Hospital, Ehime, Japan.
J Cardiol Cases. 2009 Dec 3;1(3):e129-e132. doi: 10.1016/j.jccase.2009.10.004. eCollection 2010 Jun.
In the neonatal period, the surgical mortality of palliation is extremely high for asplenia syndrome complicated by single ventricle combined with total anomalous pulmonary venous connection (TAPVC). Recently, stent implantation for the pulmonary venous drainage route soon after birth has been used instead of surgery to prevent pulmonary venous occlusion and to maintain stable hemodynamics in the neonatal period or in early infancy. Here, we successfully implanted stents in the ductus venosus (DV) in 2 neonates with asplenia syndrome complicated by infracardiac type TAPVC. The first patient was a 3-day-old male neonate with severe cyanosis. Immediately after TAPVC was diagnosed, we implanted a stent in the DV. The second patient was a 0-day-old female neonate. She was diagnosed as TAPVC by fetal echocardiogram. After the scheduled delivery, a stent was successfully implanted. We believe that stent implantation in the DV in the neonatal period is effective and less invasive than surgery in patients with infracardiac type TAPVC.
在新生儿期,对于合并单心室及完全性肺静脉异位连接(TAPVC)的无脾综合征,姑息性手术的死亡率极高。近来,出生后不久即对肺静脉引流途径进行支架植入术,以此替代手术来预防肺静脉梗阻,并在新生儿期或婴儿早期维持稳定的血流动力学。在此,我们成功地为2例合并心内型TAPVC的无脾综合征新生儿在静脉导管(DV)植入了支架。首例患者为一名3日龄重度发绀男婴。TAPVC确诊后,我们立即在DV植入了一枚支架。第二例患者是一名0日龄女婴。胎儿超声心动图诊断为TAPVC。足月分娩后,成功植入了一枚支架。我们认为,对于心内型TAPVC患者,新生儿期在DV植入支架有效且侵入性小于手术。