Paediatric Cardiology Services, Royal Brompton Hospital and Harefield NHS Foundation Trust, London, UK.
Cardiac Congenital Surgery Services, Royal Brompton Hospital and Harefield NHS Foundation Trust, London, UK.
Cardiol Young. 2023 Aug;33(8):1453-1455. doi: 10.1017/S1047951122004188. Epub 2023 Jan 6.
A patent ductus arteriosus in patients with transposition of the great arteries is usually beneficial to allow shunting between pulmonary and systemic circulations. However, if the duct is too large, it can cause haemodynamic instability, pulmonary oedema and compromised organ perfusion. We present a neonate in whom a 5 mm short and tubular ductus arteriosus was causing significant cardiac failure with necrotising enterocolitis and liver impairment, leaving him too unstable for the arterial switch operation. At day 14 of life (3.1 kg), the baby underwent successful transcatheter closure using an Amplatzer vascular plug (Abbott, Chicago, Il, USA) delivered through a 5Fr catheter from the aortic side. The procedure was uncomplicated and successful as the neonate was extubated 2 days later. He subsequently underwent successful arterial switch surgery.
动脉导管未闭在大动脉转位患者中通常是有益的，可以允许肺循环和体循环之间的分流。然而，如果导管过大，可能会导致血流动力学不稳定、肺水肿和器官灌注受损。我们介绍了一名新生儿，他的动脉导管未闭 5 毫米短而管状，导致严重的心力衰竭、坏死性小肠结肠炎和肝功能损害，使他在动脉切换手术前不稳定。在出生后 14 天（3.1 公斤），通过从主动脉侧插入的 5Fr 导管，使用 Amplatzer 血管塞（美国雅培公司，芝加哥，伊利诺伊州）成功进行了经导管闭合术。该过程简单且成功，因为新生儿在 2 天后拔管。随后，他成功地进行了动脉切换手术。
