Tan Weiyi, Stefanescu Schmidt Ada C, Horlick Eric, Aboulhosn Jamil
Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas.
Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
J Soc Cardiovasc Angiogr Interv. 2022 Aug 24;1(6):100438. doi: 10.1016/j.jscai.2022.100438. eCollection 2022 Nov-Dec.
Patients with congenital heart disease now live well into adulthood because of advances in surgical techniques, improvements in medical management, and the development of novel therapeutic agents. As patients grow older into adults with congenital heart disease, many require catheter-based interventions for the treatment of residual defects, sequelae of their initial repair or palliation, or acquired heart disease. The past 3 decades have witnessed an exponential growth in both the type and number of transcatheter interventions in patients with congenital heart disease. With improvements in medical technology and device design, including the use of devices designed for the treatment of acquired valve stenosis or regurgitation, patients who previously would have required open-heart surgery for various conditions can now undergo percutaneous cardiac catheter-based procedures. Many of these procedures are complex and occur in complex patients who are best served by a multidisciplinary team. This review aims to highlight some of the currently available transcatheter interventional procedures for adults with congenital heart disease, the clinical outcomes of each intervention, and any special considerations so that the reader may better understand both the procedure and patients with adult congenital heart disease.
由于外科技术的进步、医疗管理的改善以及新型治疗药物的研发,先天性心脏病患者如今能够很好地活到成年期。随着先天性心脏病患者步入成年,许多人需要通过导管介入治疗来处理残余缺损、初始修复或姑息治疗的后遗症,或后天性心脏病。在过去30年里,先天性心脏病患者经导管介入治疗的类型和数量呈指数级增长。随着医疗技术和器械设计的改进,包括使用用于治疗后天性瓣膜狭窄或反流的器械,以前因各种病症需要接受心脏直视手术的患者现在可以接受经皮心脏导管介入手术。这些手术中有许多都很复杂,且发生在最适合由多学科团队服务的复杂患者身上。本综述旨在强调目前一些适用于成年先天性心脏病患者的经导管介入手术、每种干预措施的临床结果以及任何特殊注意事项,以便读者能更好地理解这些手术以及成年先天性心脏病患者。