Boucek Dana M, Qureshi Athar M, Goldstein Bryan H, Petit Christopher J, Glatz Andrew C
The Cardiac Center at the Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
Congenit Heart Dis. 2019 Jan;14(1):105-109. doi: 10.1111/chd.12707.
Infants with ductal-dependent pulmonary blood flow (PBF) often undergo a palliative procedure to provide a stable source of PBF prior to definitive palliation or repair. In the current era, a surgical shunt or ductal stent is used to provide PBF. We aimed to review the current literature comparing ductal stents to surgical shunts.
Four small, single-center studies and two larger multicenter studies were identified comparing ductal stent to surgical shunt. Combined, these studies showed ductal stent resulted in similar or improved pulmonary artery growth, fewer complications, shorter length of stay, less diuretic use, and improved survival compared to surgical shunt. Despite inherent minor variability among the studies, ductal stent appears to be associated with more frequent reinterventions.
Surgical shunts remain essential to the care of these patients, but ductal stent is a reasonable alternative, and may provide some advantages in select patients with ductal-dependent PBF.
患有依赖动脉导管的肺血流（PBF）的婴儿通常会接受姑息性手术，以便在进行最终姑息治疗或修复之前提供稳定的PBF来源。在当前时代，会使用外科分流术或动脉导管支架来提供PBF。我们旨在回顾比较动脉导管支架与外科分流术的当前文献。
确定了四项小型单中心研究和两项较大的多中心研究，比较了动脉导管支架与外科分流术。综合这些研究表明，与外科分流术相比，动脉导管支架可使肺动脉生长相似或更好，并发症更少，住院时间更短，利尿剂使用更少，且生存率更高。尽管这些研究之间存在固有的微小差异，但动脉导管支架似乎与更频繁的再次干预相关。
外科分流术对于这些患者的治疗仍然至关重要，但动脉导管支架是一种合理的替代方案，并且可能在某些患有依赖动脉导管的PBF的患者中具有一些优势。
