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一名患有法洛四联症和孤立性左肺动脉的2个月大婴儿的动脉导管未闭晚期经导管再通术。

Late transcatheter recanalization of a closed ductus arteriosus in a 2-month-old infant with tetralogy of Fallot and isolated left pulmonary artery.

作者信息

Ahmed Aziez, LaCroix Gary Anthony, Bader Ishqair Anas Hasan, Shivaram Pushpa, Das Srikant

机构信息

Department of Pediatrics, Children's Heart Center, Yale University School of Medicine, New Haven, CT, USA.

Department of Pediatrics, Division of Cardiology, The University of Arkansas for Medical Sciences, Little Rock, USA.

出版信息

Ann Pediatr Cardiol. 2020 Oct-Dec;13(4):357-360. doi: 10.4103/apc.APC_168_19. Epub 2020 Sep 17.

Abstract

Ductal stenting is increasing as an alternative to surgical shunts in cyanotic newborns. However, most reports include newborns with patent ducts who are often on prostaglandin before the procedure. We report a successful late transcatheter recanalization of the closed ductus arteriosus in a 2-month-old infant with tetralogy of Fallot, right aortic arch, and an isolated left pulmonary artery (LPA). We achieved adequate LPA growth before complete repair. There were no procedural complications. This procedure is rare in Western countries due to universal pulse oximetry screening and increased fetal diagnoses. The procedure is technically challenging in the absence of any angiographic flow into the ductus. Evidence of a ductal ampulla increases the chances of success.

摘要

在患有青紫型心脏病的新生儿中,导管支架置入术作为外科分流术的替代方法正在逐渐增加。然而,大多数报告中的新生儿动脉导管未闭,且在手术前常使用前列腺素。我们报告了一例成功的经导管晚期再通术,该手术针对一名2个月大、患有法洛四联症、右位主动脉弓和孤立性左肺动脉(LPA)的婴儿的闭合动脉导管。在进行完全修复之前,我们实现了左肺动脉的充分生长。手术过程中没有并发症。由于普遍采用脉搏血氧饱和度筛查以及胎儿诊断的增加,该手术在西方国家很少见。在没有任何造影剂流入导管的情况下,该手术在技术上具有挑战性。存在导管壶腹的证据会增加成功的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d654/7727898/154436a895a5/APC-13-357-g001.jpg

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