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新生儿动脉导管支架置入术——经导管方法作为矫正手术的桥梁治疗

Ductus Arteriosus Stenting in Newborns - Transcatheter Approach as a Bridge Therapy for Corrective Surgery.

作者信息

Mahmoud Hiyam, Youssef Tammam, Cinteza Eliza, Voicu Cristiana, Balan Adrian, Margarint Irina, Filip Cristina, Nicolae Georgiana, Duica Gabriela, Nicolescu Alin, Barascu Ileana, Cirstoveanu Catalin

机构信息

"Marie Curie" Emergency Children's Hospital, Bucharest, Romania.

出版信息

Maedica (Bucur). 2022 Mar;17(1):205-210. doi: 10.26574/maedica.2022.17.1.205.

Abstract

Duct-dependent congenital heart disease requires attentive therapeutic management since the only source of pulmonary blood flow in newborns is provided by the patent ductus arteriosus. The patency of the duct is the main objective in the first hours of life and it is guaranteed by prostaglandin E1 infusion, but it is not a long-term solution for this type of cardiac malformation. In order to augment pulmonary blood, there are two types of interventions that can be performed: a classical surgical shunt or stenting of the ductus arteriosus, a fairly new alternative to cardiac palliative surgery. Case selection for this type of procedure is essential regarding the patients' outcome. We present the management of a newborn diagnosed with (pseudo)atretic pulmonary valve, large ventricular septal defect and patent ductus arteriosus, who underwent an interventional procedure to secure pulmonary blood flow by placing a drug-eluting stent in the ductus arteriosus. The patient's evolution was not uneventful, several complications appeared, but after three months of neonatal intensive care we were able to discharge him in good clinical condition.

摘要

依赖动脉导管的先天性心脏病需要精心的治疗管理,因为新生儿肺血流的唯一来源是动脉导管未闭。在出生后的最初几个小时内,保持动脉导管开放是主要目标,可通过输注前列腺素E1来保证,但这并非这类心脏畸形的长期解决方案。为增加肺血流量,可进行两种干预措施:经典的外科分流术或动脉导管支架置入术,这是心脏姑息手术的一种较新替代方法。对于这类手术,病例选择对患者的预后至关重要。我们介绍了一名被诊断为(假性)肺动脉瓣闭锁、大型室间隔缺损和动脉导管未闭的新生儿的治疗情况,该患儿接受了一项介入手术,通过在动脉导管内放置药物洗脱支架来确保肺血流。患儿的病情并非一帆风顺,出现了一些并发症,但经过三个月的新生儿重症监护,我们得以让他在良好的临床状态下出院。

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Drug-Eluting Stents Compared With Bare Metal Stents for Stenting the Ductus Arteriosus in Infants With Ductal-Dependent Pulmonary Blood Flow.
Am J Cardiol. 2019 Sep 15;124(6):952-959. doi: 10.1016/j.amjcard.2019.06.014. Epub 2019 Jun 26.
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