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体外膜肺氧合(ECMO)支持后小儿经导管房间隔支架取出术,包括使用新型取出装置

Pediatric Transcatheter Atrial Septal Stent Removal Following ECMO Support Including Use of Novel Retrieval Device.

作者信息

Coppola John-Anthony, Lo Yau Yuen, Vyas Himesh V, Peek Giles J, Jacobs Jeffrey P, Bleiweis Mark S, Fudge James C

机构信息

Division of Pediatric Cardiology, Department of Pediatrics, Congenital Heart Center, University of Florida, Gainesville, Florida, USA; Division of Pediatric Cardiology, Department of Pediatrics, University of California-Davis, Sacramento, California, USA.

Division of Pediatric Cardiology, Department of Pediatrics, Congenital Heart Center, University of Florida, Gainesville, Florida, USA.

出版信息

JACC Case Rep. 2025 Sep 3;30(26):104928. doi: 10.1016/j.jaccas.2025.104928.

Abstract

Left atrial (LA) decompression is often performed in patients on venoarterial extracorporeal membrane oxygenation to help offload the left ventricle. Atrial septal stents may be used to ensure the adequacy of LA decompression; however, if there is cardiopulmonary recovery and extracorporeal membrane oxygenation support is no longer needed, the stents require removal. We describe 3 pediatric patients who required venoarterial extracorporeal membrane oxygenation support and atrial septal stent placement who underwent successful transcatheter removal of the stents after cardiac recovery. In the initial case, snares alone were used to remove the stent. In the 2 subsequent cases, a combination of snares and the ŌNŌ retrieval device (ŌNŌCOR LLC) were used to remove the stents. Transcatheter removal offers a less invasive approach for atrial septal stent removal after extracorporeal membrane oxygenation support. To our knowledge, this series is the first report of transcatheter removal of a large diameter atrial septal stent and the first report using the ŌNŌ retrieval device.

摘要

左心房减压常用于接受静脉-动脉体外膜肺氧合治疗的患者,以帮助减轻左心室的负担。可使用房间隔支架来确保左心房减压的充分性;然而,如果心肺功能恢复且不再需要体外膜肺氧合支持,则需要取出支架。我们描述了3例需要静脉-动脉体外膜肺氧合支持并置入房间隔支架的儿科患者,他们在心脏功能恢复后成功通过导管取出了支架。在首例病例中,仅使用圈套器取出支架。在随后的2例病例中,联合使用圈套器和ŌNŌ取出装置(ŌNŌCOR LLC)取出支架。经导管取出术为体外膜肺氧合支持后取出房间隔支架提供了一种侵入性较小的方法。据我们所知,本系列是关于经导管取出大直径房间隔支架的首例报告,也是使用ŌNŌ取出装置的首例报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63f0/12426638/8e7885f871e9/ga1.jpg

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