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心上型完全性肺静脉异位引流梗阻时的抢救手术

Bailout procedure in obstructed supracardiac total anomalous pulmonary vein drainage.

作者信息

Peirone Alejandro, Contreras Alejandro, Ferrero Guadagnoli Adolfo, Juaneda Ignacio, Banille Edgardo, Francucci Víctor, Cisneros Martín, Rubio Mariano

机构信息

Programa de Cardiopatías Congénitas del Niño y del Adulto, Hospital Privado Universitario de Córdoba, Córdoba, Argentina. E-mail:

Sección de Cardiología Intervencionista, Sanatorio Francés, Córdoba, Argentina.

出版信息

Medicina (B Aires). 2021;81(2):282-285.

Abstract

Total anomalous pulmonary venous drainage is a rare and diverse anomaly, accounting for 1% to 3% of patients with congenital heart disease. Newborns with diagnosis of an obstructed total anomalous pulmonary venous dainage are extremely ill soon after birth and often present with severe cyanosis, pulmonary hypertension and low cardiac output requiring urgent surgical intervention. Transcatheter palliative stenting of the obstructive vertical vein can be an acceptable alternative as a bailout intervention before complete surgical correction is undertaken. This report of two cases highlights the feasibility, safety and effectiveness of the interventional palliative procedure and confirms that this technique can be an acceptable and attractive bridge in the algorithm of medical decisions during the evaluation of these critical patients.

摘要

完全性肺静脉异位引流是一种罕见且多样的先天性心脏畸形,占先天性心脏病患者的1%至3%。诊断为梗阻性完全性肺静脉异位引流的新生儿出生后不久病情极为严重,常表现为严重青紫、肺动脉高压和低心输出量,需要紧急手术干预。在进行完全手术矫正之前,经导管对梗阻性垂直静脉进行姑息性支架置入可作为一种可接受的替代救助干预措施。本两例报告强调了介入性姑息治疗的可行性、安全性和有效性,并证实该技术在评估这些重症患者的医疗决策流程中可作为一种可接受且有吸引力的过渡手段。

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