Meliota Giovanni, Lombardi Maristella, Zaza Pierluigi, Tagliente Maria Rosaria, Vairo Ugo
Department of Paediatric Cardiology, Giovanni XXIII Paediatric Hospital, Bari, Italy.
Ann Pediatr Cardiol. 2020 Jan-Mar;13(1):67-71. doi: 10.4103/apc.APC_2_19. Epub 2019 Oct 9.
Balloon angioplasty may be performed as the first treatment of aortic coarctation to stabilize newborns too sick for immediate surgery. The issue of vascular access is the key to the successful treatment of critical newborns. In our study, we argue that the lesser-known axillary access route is the safest and most effective route of vascular access for balloon angioplasty in infants with aortic coarctation. To support this argument, we present the case of eight unstable newborns with complex heart diseases, who were successfully treated with percutaneous intervention through the axillary artery. This case series is followed by an analysis of the greater efficacy of this technique compared to the more conventional femoral and carotid routes. We conclude by acknowledging the substantial advantages of this lesser-known vascular access and advocate its more widespread clinical implementation in the treatment of critical newborns.
对于病情过重无法立即进行手术的新生儿,可将球囊血管成形术作为主动脉缩窄的首选治疗方法。血管通路问题是救治危重新生儿成功的关键。在我们的研究中,我们认为鲜为人知的腋动脉通路是主动脉缩窄婴儿进行球囊血管成形术最安全、最有效的血管通路。为支持这一观点,我们介绍了8例患有复杂心脏病的不稳定新生儿的病例,他们通过腋动脉成功接受了经皮介入治疗。本病例系列之后,分析了该技术与更传统的股动脉和颈动脉通路相比具有更高的疗效。我们最后承认这种鲜为人知的血管通路具有诸多优势,并提倡在救治危重新生儿时更广泛地在临床中应用。