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使用KONAR-MF™室间隔缺损封堵器经导管封堵新生儿大型肺动静脉瘘

Neonatal Transcatheter Closure of a Large Pulmonary Arteriovenous Fistula with a KONAR-MF™ VSD Occluder.

作者信息

Callegari Alessia, Bonnet Damien, Malekzadeh-Milani Sophie

机构信息

Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Rue de Sèvres, 75015, Paris, France.

Université de Paris Cité, Paris, France.

出版信息

Pediatr Cardiol. 2025 Mar 17. doi: 10.1007/s00246-025-03830-8.

Abstract

Pulmonary arteriovenous fistulas (PAVFs) are rare congenital anomalies characterized by abnormal vascular connections that bypass the capillary bed, causing hypoxemia, cyanosis, and systemic embolic risks. Early diagnosis and intervention are critical to prevent complications, particularly in neonates with severe right-to-left shunts. This report describes the first documented case of neonatal transcatheter closure of a large PAVF using a KONAR-MF™ VSD Occluder (MFO). A 1-day-old neonate with a prenatally diagnosed PAVF presented with oxygen saturation of 82%. Angiographic and echocardiographic assessments confirmed the presence of a large PAVF between the right pulmonary artery and right inferior pulmonary vein. The fistula was successfully closed using an 8 × 6 mm MFO device, with no complications. Post-procedure, oxygen saturation improved to 100%, and follow-up at 5 months demonstrated sustained closure. This report highlights the safety and versatility of the MFO occluder in complex cardiac cases, offering a minimally invasive alternative to surgical intervention.

摘要

肺动静脉瘘(PAVF)是一种罕见的先天性异常,其特征是血管连接异常,绕过毛细血管床,导致低氧血症、发绀和全身栓塞风险。早期诊断和干预对于预防并发症至关重要,尤其是对于有严重右向左分流的新生儿。本报告描述了首例使用KONAR-MF™室间隔缺损封堵器(MFO)经导管闭合大型PAVF的新生儿病例。一名产前诊断为PAVF的1日龄新生儿,氧饱和度为82%。血管造影和超声心动图评估证实右肺动脉和右下肺静脉之间存在大型PAVF。使用8×6mm的MFO装置成功闭合了瘘管,无并发症。术后,氧饱和度提高到100%,5个月的随访显示封堵持续有效。本报告强调了MFO封堵器在复杂心脏病例中的安全性和多功能性,为手术干预提供了一种微创替代方案。

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