Varan Birgül, Tokel N Kürşad, Yakut Kahraman, Erdoğan İlkay, Özkan Murat
Department of Pediatric Cardiology, Başkent University Faculty of Medicine, Ankara, Turkey.
Department of Cardiovascular Surgery, Başkent University Faculty of Medicine, Ankara, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2019 Jun 21;27(3):304-313. doi: 10.5606/tgkdc.dergisi.2019.17229. eCollection 2019 Jul.
The aim of this study was to evaluate the early and mid-term results of interventional cardiac catheterization and procedure-related complications in infants weighing <2,000 g.
Between May 1998 and April 2017, 22 patients (14 males, 8 females; mean age 14±8.4 days; range, 1 to 30 days) weighing <2,000 g who underwent a total of 23 interventional cardiac catheterization were retrospectively analyzed. Procedures were balloon coarctation angioplasty in 14, balloon atrial septostomy in five, balloon aortic valvuloplasty in one, balloon pulmonary valvuloplasty in one, patent ductus arteriosus closure in one, and stent placement in the ductus in one patient. Another patient underwent balloon coarctation angioplasty and balloon aortic valvuloplasty in the same session.
The overall success rate of the interventional procedures was 95.6%. The mean follow-up was 3.2±1.6 years (range, 1 to 5.5) for 18 patients with available records. The rate of serious complications was 18%. The most frequent complications in the early period were low hemoglobin levels requiring erythrocyte suspension transfusion (54.5%) and vascular injury (54.5%). Two patients required reintervention, one patient required surgery after the second intervention, and three patients required only surgery. Six patients underwent palliative interventional procedures, and interventional procedures led to definitive treatment in five patients.
The mortality and morbidity rate of surgery is high in premature under 2,000 g infants and interventional heart catheterization can be life-saving in this patient group, although it is associated with significant complications in low birth weight newborns.
本研究旨在评估体重<2000g婴儿的介入性心导管检查的早期和中期结果以及与手术相关的并发症。
回顾性分析1998年5月至2017年4月期间22例体重<2000g的患者(14例男性,8例女性;平均年龄14±8.4天;范围1至30天),这些患者共接受了23次介入性心导管检查。手术包括14例球囊缩窄血管成形术、5例球囊房间隔造口术、1例球囊主动脉瓣成形术、1例球囊肺动脉瓣成形术、1例动脉导管未闭封堵术以及1例患者的动脉导管内支架置入术。另1例患者在同一次手术中接受了球囊缩窄血管成形术和球囊主动脉瓣成形术。
介入手术的总体成功率为95.6%。对18例有可用记录的患者进行了平均3.2±1.6年(范围1至5.5年)的随访。严重并发症发生率为18%。早期最常见的并发症是需要输注红细胞悬液的低血红蛋白水平(54.5%)和血管损伤(54.5%)。2例患者需要再次干预,1例患者在第二次干预后需要手术,3例患者仅需要手术。6例患者接受了姑息性介入手术,5例患者通过介入手术得到了确定性治疗。
体重<2000g的早产婴儿手术的死亡率和发病率较高,尽管低出生体重新生儿介入性心导管检查会伴有严重并发症,但对该患者群体而言可能挽救生命。