Division of Cardiology, Children's Hospital of Michigan, Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA; Department of Pediatric Cardiology, Osaka City General Hospital Pediatric Medical Center, Osaka, Japan.
Division of Cardiology, Children's Hospital of Michigan, Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA.
J Cardiol. 2021 Jan;77(1):23-29. doi: 10.1016/j.jjcc.2020.08.009. Epub 2020 Sep 17.
The aim of this study was to evaluate the diagnostic utility of cardiac catheterization and the efficacy of transcatheter intervention in patients with hemoptysis.
Cardiac catheterization may play a role in identifying the etiologies of hemoptysis with the potential for transcatheter intervention.
This was a retrospective study of all the patients who were brought to the pediatric cardiac catheterization laboratory for the indication of hemoptysis over a 15-year period (2006-2020).
Twenty-one patients underwent 28 cardiac catheterizations. The median age was 17.4 years (range 0.3-60.0 years), and the underlying cardiac diagnoses were normal heart n = 3, pulmonary hypertension 1, heart transplant 1, pulmonary arteriovenous malformation 1, pulmonary vein disease 3, biventricular congenital heart diseases 5, and single ventricles 7. The diagnostic utility of catheterization was 81% (17/21). At two-thirds (18/28) of catheterizations, transcatheter interventions were performed in 14/21 (67%) patients: aortopulmonary collateral embolization 14, aortopulmonary and veno-venous collateral embolization 1, and pulmonary arteriovenous malformation embolization 3. Although recurrent hemoptysis was frequent (50%) post-intervention, the final effectiveness of transcatheter interventions was 79% (11/14 patients). Overall mortality was 19% (4/21), all in those presenting with massive hemoptysis.
Cardiac catheterization was shown to have good diagnostic utility for hemoptysis especially in patients with underlying congenital heart disease. Despite the high mortality and recurrent hemoptysis rate, transcatheter interventions were effective in our cohort.
本研究旨在评估心脏导管检查对咯血患者的诊断效用和经导管介入治疗的疗效。
心脏导管检查可能有助于确定咯血的病因，并有可能进行经导管介入治疗。
这是一项回顾性研究，纳入了在过去 15 年（2006 年至 2020 年）期间因咯血而被送入儿科心脏导管实验室的所有患者。
21 例患者共行 28 次心脏导管检查。中位年龄为 17.4 岁（范围 0.3-60.0 岁），基础心脏诊断为正常心脏 3 例、肺动脉高压 1 例、心脏移植 1 例、肺动静脉畸形 1 例、肺静脉疾病 3 例、双心室先天性心脏病 5 例和单心室 7 例。导管检查的诊断效能为 81%（17/21）。在三分之二（18/28）的导管检查中，对 21 例患者中的 14 例（67%）进行了经导管介入治疗：体肺侧支动脉栓塞 14 例、体肺和肺静脉侧支动脉栓塞 1 例、肺动静脉畸形栓塞 3 例。尽管介入治疗后咯血复发较为常见（50%），但经导管介入治疗的最终有效率为 79%（11/14 例患者）。总死亡率为 19%（4/21），均发生在大量咯血的患者中。
心脏导管检查对咯血具有良好的诊断价值，尤其是在患有基础先天性心脏病的患者中。尽管死亡率和咯血复发率较高，但经导管介入治疗在本研究队列中是有效的。
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