Paediatric Intensive Care Unit.
Departments of Paediatric Cardiology.
J Bronchology Interv Pulmonol. 2020 Jul;27(3):200-204. doi: 10.1097/LBR.0000000000000654.
We report our experience of the biodegradable polydioxanone stent in cases of bronchial compression by a dilated left atrium in children with heart disease.
Eight custom-made biodegradable stents were inserted into the left main bronchus in 5 patients diagnosed with critical airway compression. Four of the 5 patients were ventilator-dependent with significant cardiac morbidity.
Stents were inserted without complication under fluoroscopic guidance. All experienced improvement in symptoms over time. In 3 patients, repeat bronchial stenting was performed where stent degradation was associated with recurrence of vascular airway compression and symptoms. No stents migrated nor was there evidence of bronchial or vascular erosion. There was 1 death, unrelated to the stent, and all remaining survivors were well at a 2-year follow-up.
The use of the polydioxanone biodegradable stent appeared safe in this cohort of critically ill patients with vascular bronchial compression. There use may aid weaning from mechanical ventilation and support eventual cardiac recovery.
我们报告了在患有心脏病的儿童中，使用可生物降解的聚二氧杂环己酮支架治疗因左心房扩张导致的支气管压迫的经验。
5 例诊断为严重气道压迫的患者中，有 5 例使用 8 个定制的可生物降解支架插入左主支气管。5 例患者中有 4 例依赖呼吸机，且存在严重的心脏并发症。
在透视引导下，支架插入无并发症。所有患者的症状随时间的推移均有所改善。在 3 例患者中，由于支架降解与血管气道压迫和症状复发相关，再次进行支气管支架置入。没有支架迁移，也没有支气管或血管侵蚀的证据。有 1 例死亡与支架无关，所有其余幸存者在 2 年随访时情况良好。
在这组患有血管性支气管压迫的危重病患者中，使用聚二氧杂环己酮可生物降解支架似乎是安全的。它的使用可能有助于从机械通气中脱机，并支持最终的心脏恢复。
