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经导管肺动脉去带术:对每个患者都有效吗?

Transcatheter pulmonary artery debanding: Is it effective in every patient?

作者信息

Demir İbrahim Halil, Özdemir Dursun Muhammed, Ergin Selma Oktay, Yücel İlker Kemal, Sürücü Murat, Çiçek Murat, Aydemir Numan Ali, Çelebi Ahmet

机构信息

Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Türkiye.

Departmen of Pediatric Cardiology, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul, Türkiye.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Oct 30;32(4):367-377. doi: 10.5606/tgkdc.dergisi.2024.26234. eCollection 2024 Oct.

Abstract

BACKGROUND

This study aimed to present our experience with transcatheter pulmonary debanding, focusing on patient outcomes.

METHODS

The retrospective study was conducted with 32 patients (17 males, 15 females; mean age: 3.6±2 years; range, 0.5 to 8.8 years) who underwent transcatheter pulmonary debanding between January 2010 and January 2024. The patients were evaluated in two groups. In Group 1 (n=24), total debanding was targeted for patients with spontaneously closed or restrictive ventricular septal defects or those suitable for transcatheter ventricular septal defect closure. In Group 2 (n=8), palliative debanding was utilized in children with ongoing band requirement.

RESULTS

The median body weight was 15 kg. In Group 1, the mean right ventricle-to-aortic pressure ratio (RVp/Aop) was 0.91±0.21 before the procedure, which decreased to a mean of 0.33±0.20 after the procedure. In Group 2, the mean RVp/Aop was 1.31±0.47, which decreased to 0.77±0.13 after transcatheter palliative debanding. The mean peripheral oxygen saturation was 80±6% before the procedure and 94±2.5% after the procedure. Transcatheter debanding was successful in all patients when surgical pulmonary banding was performed with 6-0 Prolene and polytetrafluoroethylene band material.

CONCLUSION

Transcatheter banding is a safe and effective procedure that minimizes the need for reoperation.

摘要

背景

本研究旨在介绍我们经导管肺动脉解带术的经验,重点关注患者预后。

方法

对2010年1月至2024年1月期间接受经导管肺动脉解带术的32例患者(17例男性,15例女性;平均年龄:3.6±2岁;范围0.5至8.8岁)进行回顾性研究。患者分为两组进行评估。第1组(n = 24),对于室间隔缺损自发闭合或限制性室间隔缺损患者或适合经导管室间隔缺损封堵的患者,目标是完全解带。第2组(n = 8),对于仍需要束带的儿童采用姑息性解带。

结果

中位数体重为15kg。第1组,术前右心室与主动脉压力比值(RVp/Aop)平均为0.91±0.21,术后降至平均0.33±0.20。第2组,术前RVp/Aop平均为1.31±0.47,经导管姑息性解带术后降至0.77±0.13。术前平均外周血氧饱和度为80±6%,术后为94±2.5%。当使用6-0普理灵和聚四氟乙烯束带材料进行外科肺动脉束带术时,经导管解带在所有患者中均成功。

结论

经导管束带术是一种安全有效的手术,可最大程度减少再次手术的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c76/11620524/0b979c4ed0f3/TJTCS-2024-32-4-367-377-F1.jpg

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