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[血管内支架治疗先天性心脏缺陷手术患者的残余肺动脉狭窄;初步结果]

[Endovascular stent in the treatment of residual pulmonary stenosis in patients operated on for congenital heart defects; initial results].

作者信息

van Oort A M, Tanke R B, Oyen W J, van Mill G J, Aengevaeren W R

机构信息

Kinderhartcentrum, Academisch Ziekenhuis, Nijmegen.

出版信息

Ned Tijdschr Geneeskd. 1995 Jun 10;139(23):1182-7.

PMID:7791925
Abstract

OBJECTIVE

Evaluation of the preliminary results of stent implantation as a new technique of intervention cardiology to treat (residual) stenosis of pulmonary arteries in congenital heart disease.

DESIGN

Descriptive.

SETTING

Children's Heart Centre, University Hospital Nijmegen, the Netherlands.

METHODS

Data about physical condition, heart catheterization/angiography and lung perfusion scan were collected. Special attention was paid to the lung perfusion scan as a potential parameter of evaluation.

RESULTS

The physical condition was not a useful parameter to judge the result of the pulmonary intravascular stenting, due to a simultaneously present important pulmonary valve insufficiency in most cases. Angiography showed a good result immediately after the procedure in all cases, except in one with kinking of the stent. The increase of lung perfusion could be confirmed by lung scintigraphy in most cases. The relative perfusion of the affected lung increased from 22.7% (SD: 10.8) to 38.6% (12.3) (p < or = 0.001).

CONCLUSION

Percutaneous implantation of endovascular stents in pulmonary artery branch stenosis is a welcome alternative to (reconstructive) cardiac surgery. Objective quantification of this stenting by lung perfusion scintigraphy, a technique without patient discomfort, is possible.

摘要

目的

评估支架植入术作为介入心脏病学的一项新技术,用于治疗先天性心脏病中肺动脉(残余)狭窄的初步结果。

设计

描述性研究。

地点

荷兰奈梅亨大学医学中心儿童心脏中心。

方法

收集有关身体状况、心导管检查/血管造影和肺灌注扫描的数据。特别关注肺灌注扫描作为一个潜在的评估参数。

结果

由于大多数病例同时存在严重的肺动脉瓣关闭不全,身体状况并非判断肺血管内支架置入术结果的有用参数。血管造影显示,除1例支架扭结外,所有病例术后即刻效果良好。大多数病例中,肺灌注增加可通过肺闪烁显像得到证实。患侧肺的相对灌注从22.7%(标准差:10.8)增加到38.6%(12.3)(p≤0.001)。

结论

经皮肺动脉分支狭窄血管内支架植入术是(重建性)心脏手术的一个受欢迎的替代方法。通过肺灌注闪烁显像对这种支架置入术进行客观量化是可行的,该技术不会给患者带来不适。

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