Prakoso Radityo, Kurniawati Yovi, Siagian Sisca Natalia, Sembiring Aditya Agita, Sakti Damba Dwisepto Aulia, Mendel Brian, Pratiwi Indah, Lelya Olfi, Lilyasari Oktavia
Division of Pediatric Cardiology and Congenital Heart Disease, Department of Cardiology and Vascular Medicine, National Cardiovascular Center of Harapan Kita, Universitas Indonesia, Jakarta, Indonesia.
Department of Cardiology and Vascular Medicine, Sultan Sulaiman Government Hospital, Serdang Bedagai, Indonesia.
Front Cardiovasc Med. 2024 Feb 1;11:1340570. doi: 10.3389/fcvm.2024.1340570. eCollection 2024.
The purpose of this study was to assess the clinical outcome after right ventricular outflow tract (RVOT) stenting in late presenter patient with unrepaired Fallot physiology.
In younger patients, RVOT stenting is an alternative to mBTT shunt; however, there have been few reports of this palliative technique in late presenter population, including adults.
This was a single-center, retrospective study of nonrandomized, palliated Fallot patients. Clinical outcomes such as left ventricular ejection fraction and saturation were measured in 32 individuals following RVOT stenting in adults ( = 10) and children ( = 22). The Statistical Package for Social Science (SPSS) 26.0 software was used to analyze the statistical data.
During the procedure, the average stent diameter and length were 8.84 ± 1.64 mm and 35.46 ± 11.23 mm, respectively. Adult patients received slightly longer stents than pediatric patients (43.60 ± 11.64 mm vs. 31.77 ± 9.07 mm). Overall, patients' saturation increased from 58.56 ± 19.03% to 91.03 ± 8.98% ( < 0.001), as did their left ventricular ejection fraction (LVEF) from 64.00 ± 18.21% to 75.09 ± 12.98% ( = 0.001). Three patients improved their LVEF from 31 to 55%, 31 to 67%, and 26 to 50%. The median length of stay was 8 (2-35) days, with an ICU stay of 2 (0-30) days. The median time from RVOT stent palliation to total repair was 3 months (range: 1 month-12 months).
RVOT stenting is a safe and effective method for increasing saturation and ejection fraction not only in newborn infants but also in late presenters, including adults with unrepaired Fallot physiology.
本研究旨在评估右心室流出道(RVOT)支架置入术在法洛四联症未修复生理状态的晚期就诊患者中的临床疗效。
在年轻患者中,RVOT支架置入术是改良布劳克-陶西格分流术(mBTT)的替代方法;然而,关于这种姑息治疗技术在包括成人在内的晚期就诊人群中的报道很少。
这是一项对非随机姑息性法洛四联症患者的单中心回顾性研究。在32例成人(n = 10)和儿童(n = 22)接受RVOT支架置入术后,测量其左心室射血分数和血氧饱和度等临床指标。使用社会科学统计软件包(SPSS)26.0软件进行统计数据分析。
手术过程中,支架的平均直径和长度分别为8.84±1.64毫米和35.46±11.23毫米。成年患者接受的支架略长于儿科患者(43.60±11.64毫米对31.77±9.07毫米)。总体而言,患者的血氧饱和度从58.56±19.03%提高到91.03±8.98%(P < 0.001),左心室射血分数(LVEF)从64.00±18.21%提高到75.09±12.98%(P = 0.001)。3例患者的LVEF分别从31%提高到55%、从31%提高到67%以及从26%提高到50%。中位住院时间为8(2 - 35)天,重症监护病房(ICU)住院时间为2(0 - 30)天。从RVOT支架姑息治疗到完全修复的中位时间为3个月(范围:1个月 - 12个月)。
RVOT支架置入术不仅对新生儿,而且对包括法洛四联症未修复生理状态的成人在内的晚期就诊患者来说,都是一种提高血氧饱和度和射血分数的安全有效的方法。