Moore John W
Emeritus UC San Diego School of Medicine, 9640 Deer Trail Drive, San Diego, CA, 92127, USA.
Pediatr Cardiol. 2024 Nov 25. doi: 10.1007/s00246-024-03714-3.
This article provides a historical review and a current perspective on the procedures used to palliate cyanosis in ductal-dependent infants. Eighty years ago, Helen Taussig, Alfred Blalock and Vivien Thomas developed the first effective treatment. The Blalock-Taussig-Thomas (BTT) shunt is the historical predecessor of both the contemporary modified BTT shunt and interventional stenting of the Patent Ductus Arteriosus (PDA). The surgical shunt was firmly established therapy before catheterization was born, and PDA stenting was not possible until the technologies designed to address coronary heart disease were developed. The momentum of long-established surgical therapy inhibited clinical development of PDA stenting. Nevertheless, available clinical outcomes, though limited, appear to favor PDA stenting, and first-line therapy may be shifting from the modified BTT shunt to PDA stenting. More definitive data should arise from a randomized controlled trial.
本文对用于缓解依赖导管的婴儿紫绀的治疗方法进行了历史回顾和当前展望。八十年前，海伦·陶西格、阿尔弗雷德·布莱洛克和维维恩·托马斯开发出了第一种有效治疗方法。布莱洛克-陶西格-托马斯（BTT）分流术是当代改良BTT分流术和动脉导管未闭（PDA）介入支架植入术的历史前身。在导管插入术出现之前，外科分流术就是一种成熟的治疗方法，而在用于治疗冠心病的技术得到发展之前，PDA支架植入术是不可能实现的。长期存在的外科治疗的势头抑制了PDA支架植入术的临床发展。尽管如此，现有的临床结果虽然有限，但似乎更支持PDA支架植入术，一线治疗可能正从改良BTT分流术转向PDA支架植入术。更确切的数据应该来自一项随机对照试验。
