Critser Paul J, Evers Patrick D, McGovern Eimear, Cash Michelle, Hirsch Russel
Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Division of Pediatric Cardiology, Oregon Health and Science University, Portland, OR, USA.
Pulm Circ. 2020 Nov 19;10(4):2045894020958970. doi: 10.1177/2045894020958970. eCollection 2020 Oct-Dec.
Balloon atrial septostomy is a palliative procedure currently used to bridge medically refractory pulmonary hypertension patients to lung transplantation. In the current report, we present balloon atrial septostomy as an initial therapy for high-risk pediatric pulmonary hypertension patients at our institution. Nineteen patients with median age of 4.3 years (range 0.1-14.3 years) underwent balloon atrial septostomy during initial admission for pulmonary hypertension. There were no procedural complications or deaths within 24 h of balloon atrial septostomy. Patients were followed for a median of 2.6 years (interquartile range 1.0-4.8 years). Three (16%) patients died, 3 (16%) underwent lung transplantation, and 1 (5%) underwent reverse Potts shunt. Transplant-free survival at 30 days, 1 year, and 3 years was 84%, 76%, and 67% respectively. This single-center experience suggests early-BAS in addition to pharmacotherapy is safe and warrants consideration in high-risk pediatric pulmonary hypertension patients.
球囊房间隔造口术是一种姑息性手术，目前用于将药物治疗难治的肺动脉高压患者过渡到肺移植。在本报告中，我们介绍了球囊房间隔造口术作为我院高危儿科肺动脉高压患者的初始治疗方法。19例中位年龄为4.3岁（范围0.1 - 14.3岁）的患者在因肺动脉高压首次入院期间接受了球囊房间隔造口术。球囊房间隔造口术后24小时内无手术并发症或死亡。患者的中位随访时间为2.6年（四分位间距1.0 - 4.8年）。3例（16%）患者死亡，3例（16%）接受了肺移植，1例（5%）接受了Potts分流术逆转。30天、1年和3年的无移植生存率分别为84%、76%和67%。这项单中心经验表明，除药物治疗外，早期球囊房间隔造口术是安全的，值得高危儿科肺动脉高压患者考虑。
