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婴儿体外膜肺氧合支持下经导管治疗危及生命的肺动静脉瘘

Transcatheter management of life-threatening pulmonary arteriovenous fistula with extracorporeal membrane oxygenation support in an infant.

作者信息

Guvenc Osman, Odemis Ender, Saygi Murat, Onalan M Akif

机构信息

Department of Pediatric Cardiology, Medical Faculty, Acıbadem University, Istanbul, Turkey.

Department of Pediatric Cardiology, Medical Faculty, Koc University, Istanbul, Turkey.

出版信息

Cardiol Young. 2023 Mar;33(3):498-501. doi: 10.1017/S1047951122002724. Epub 2022 Sep 1.

Abstract

Pulmonary arteriovenous malformation is a rare disease leading to cyanosis, where there is a direct relation between the pulmonary artery and pulmonary vein without a capillary structure. Arteriovenous fistulae may be single or multiple. Clinical signs emerge depending on the size of the fistulae and amount of shunt. Due to the advancements in transcatheter devices and increased experience render enable the fistula embolisation procedure as an alternative to surgical treatment. Extracorporeal membrane oxygenation is used to support the patient haemodynamically and respirationally in cases of treatment-resistant, severe and revocable cardiac or pulmonary sufficiency. This paper presents an infant patient with pulmonary arteriovenous malformation, who had haemodynamic instability due to severe hypoxia and received successful transcatheter fistula embolisation via extracorporeal membrane oxygenation under emergency conditions.

摘要

肺动静脉畸形是一种导致发绀的罕见疾病,其肺动脉与肺静脉之间存在直接联系,且无毛细血管结构。动静脉瘘可能是单个或多个。临床症状取决于瘘的大小和分流的量。由于经导管装置的进步和经验的增加,使瘘栓塞术成为手术治疗的替代方法。对于治疗抵抗、严重且可逆的心脏或肺功能不全的病例,体外膜肺氧合用于在血流动力学和呼吸方面支持患者。本文介绍了一名患有肺动静脉畸形的婴儿患者,该患者因严重缺氧导致血流动力学不稳定,并在紧急情况下通过体外膜肺氧合成功接受了经导管瘘栓塞术。

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