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儿科心脏介入治疗:来自印度的创新成果。

Pediatric cardiac interventions: Innovations from India.

作者信息

Mantoo Mohsin Raj, Ramakrishnan Sivasubramanian

机构信息

Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Ann Pediatr Cardiol. 2024 Jul-Aug;17(4):233-242. doi: 10.4103/apc.apc_196_24. Epub 2024 Nov 15.

Abstract

India, owing to its population structure, faces an enormous burden of children born with congenital heart disease (CHD). Systematic challenges such as limited public health infrastructure, a shortage of trained specialists, and high out-of-pocket expenditures hinder uniform access to comprehensive CHD care. Despite these limitations, Indian pediatric cardiologists have delivered innovative and often cost-effective solutions to challenging clinical problems. Indigenous devices such as the MyVal transcatheter heart valve, Konar-MF (multifunction) occluder, and Zephyr large-diameter stents are significant achievements in their respective fields. Static balloon dilatation of interatrial septum and balloon-assisted atrial septal defect (ASD) device implantation are prime examples of many innovations that were established by Indians and followed across the world. India also helped consolidate significant interventions in children, such as percutaneous transvenous mitral commissurotomy and interventions for aortoarteritis. Notably, Indian centers have published some of the largest series on transcatheter closure of sinus venosus ASD and ruptured sinus of Valsalva aneurysm. Close collaboration with adult coronary interventionalists has facilitated innovations borrowed from coronary chronic total occlusion hardware and techniques to recanalize ductus arteriosus or membranous-type pulmonary atresia. This manuscript discusses some of India's innovative contributions to the field of pediatric cardiac interventions.

摘要

由于其人口结构,印度面临着先天性心脏病(CHD)患儿的巨大负担。有限的公共卫生基础设施、训练有素的专家短缺以及高额的自付费用等系统性挑战阻碍了人们普遍获得全面的CHD护理。尽管存在这些限制,印度儿科心脏病专家为具有挑战性的临床问题提供了创新且往往具有成本效益的解决方案。诸如MyVal经导管心脏瓣膜、Konar-MF(多功能)封堵器和Zephyr大直径支架等本土设备在各自领域都取得了重大成就。房间隔静态球囊扩张术和球囊辅助房间隔缺损(ASD)装置植入术是印度人开创并在全球得到推广的众多创新的主要例子。印度还帮助巩固了对儿童的重大干预措施,如经皮经静脉二尖瓣交界切开术和主动脉动脉炎的干预措施。值得注意的是,印度的一些中心发表了关于静脉窦型ASD经导管封堵术和瓦氏窦瘤破裂的一些最大系列研究。与成人冠状动脉介入专家的密切合作促进了从冠状动脉慢性完全闭塞硬件和技术中借鉴创新,以再通动脉导管或膜性肺动脉闭锁。本文讨论了印度在儿科心脏介入领域的一些创新贡献。

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本文引用的文献

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Percutaneous closure of aortopulmonary window in a preterm infant.早产儿动脉导管未闭的经皮封堵术。
Ann Pediatr Cardiol. 2024 May-Jun;17(3):204-206. doi: 10.4103/apc.apc_57_24. Epub 2024 Oct 1.
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Safety and feasibility of transcatheter closure of atrial septal defects in small children weighing less than 10 kg.
Cardiol Young. 2024 Nov;34(11):2449-2456. doi: 10.1017/S1047951124025897. Epub 2024 Oct 10.
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Pediatric cardiac procedures in India: Who bears the cost?印度的儿科心脏手术:费用由谁承担?
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