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三维打印引导下经皮导管主动脉缩窄置换术:一项回顾性研究。

Three-dimensional printing-guided percutaneous transcatheter replacement in coarctation of the aorta: a retrospective study.

作者信息

He Qing, Xu Chennian, Liu Yang, Jin Ping, Zhai Mengen, Qiao Rui, Tian Zhiyuan, Cui Bin, Yang Jian

机构信息

Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, China.

Key Laboratory of Gastrointestinal Pharmacology of Chinese Materia Medica of the State Administration of Traditional Chinese Medicine, Department of Pharmacology, School of Pharmacy, Air Force Medical University, Xi'an, Shaanxi, China.

出版信息

Front Cardiovasc Med. 2024 Dec 13;11:1429470. doi: 10.3389/fcvm.2024.1429470. eCollection 2024.

Abstract

BACKGROUND

To evaluate the feasibility, effectiveness and assistant effect of 3D printed aortic model in the treatment on congenital coarctation of the aorta (CoA) in adolescents and adults.

METHODS

From December 2018 to December 2023, a total of 10 patients with congenital coarctation of aorta underwent percutaneous balloon dilatation covered stent implantation in the department of cardiovascular surgery, Xijing Hospital. There were 6 males and 4 females whose average age was (27.68 ± 13.45) years. One case complicated with ventricular septal defect (VSD). The CT data of aorta were collected before operation, and the aorta was reconstructed by Mimics software and printed with 3D printing technology. The operation simulation was performed before operation to determine the best operation plan. The clinical data during hospitalization and follow-up were analyzed.

RESULTS

All the patients of CoA were successfully treated with percutaneous balloon dilatation covered stent implantation. The narrowest average diameter of CoA increased from (4.35 ± 2.61) mm before operation to (16.84 ± 1.99) mm immediately after operation ( < 0.05). The mean transconstrictive systolic pressure difference decreased from (81.29 ± 18.72) mmHg before operation to (15.52 ± 7.47) mmHg after operation ( < 0.05). The mean systolic blood pressure of the right upper limb decreased from (182.05 ± 38.99) mmHg preoperatively to (141.95 ± 32.11) mmHg postoperatively ( < 0.05). The mean systolic blood pressure of the lower limb increased from (121.52 ± 27.84) mmHg preoperatively to (131.81 ± 32.39) mmHg postoperatively ( < 0.05). Two patients with PDA and VSD underwent interventional occlusion at the same time without shunt. During the period of hospitalization and follow-up, there were significant cardiovascular complications.

CONCLUSIONS

Percutaneous balloon dilatation covered stent implantation is effective in the treatment of adolescents and adults with CoA in the short and medium term, with fewer complications, and the long-term effect needs furthshdie1er study.

摘要

背景

评估3D打印主动脉模型在青少年及成人先天性主动脉缩窄(CoA)治疗中的可行性、有效性及辅助作用。

方法

2018年12月至2023年12月,西京医院心血管外科共10例先天性主动脉缩窄患者接受经皮球囊扩张覆膜支架植入术。其中男性6例,女性4例,平均年龄(27.68±13.45)岁。1例合并室间隔缺损(VSD)。术前采集主动脉CT数据,通过Mimics软件重建主动脉并采用3D打印技术打印。术前进行手术模拟以确定最佳手术方案。分析住院及随访期间的临床资料。

结果

所有CoA患者均成功接受经皮球囊扩张覆膜支架植入术治疗。CoA最窄平均直径由术前(4.35±2.61)mm增至术后即刻(16.84±1.99)mm(P<0.05)。平均跨缩窄段收缩压差由术前(81.29±18.72)mmHg降至术后(15.52±7.47)mmHg(P<0.05)。右上肢平均收缩压由术前(182.05±38.99)mmHg降至术后(141.95±32.11)mmHg(P<0.05)。下肢平均收缩压由术前(121.52±27.84)mmHg升至术后(131.81±32.39)mmHg(P<0.05)。2例合并动脉导管未闭(PDA)和VSD患者同期行介入封堵,无分流。住院及随访期间无明显心血管并发症。

结论

经皮球囊扩张覆膜支架植入术治疗青少年及成人CoA在中短期内有效,并发症较少,长期效果有待进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4587/11672784/90675fe04c5f/fcvm-11-1429470-g001.jpg

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