Ramírez A, Hernández I, Arcile G, Farrú O, Silva A M, Quispe P
Centro Cardiovascular Hospital Clínico, Universidad de Chile, Santiago de Chile.
Rev Med Chil. 1993 Mar;121(3):301-6.
The report of a female patient with tricuspid atresia and severe stenosis of the pulmonary artery, stenosis of the left pulmonary-systemic shunt and occlusion of the right systemic-pulmonary shunt.
The use of transluminal angioplasty has been extended to the treatment of several congenital cardiopathies and, in some of them, it is the therapeutic procedure of choice.
Dilatation of the distal stenosis of the pulmonary-systemic shunt with a coaxial system composed initially by an 8 French right Judkins carrier catheter with a soft tip through which a 0.014" (0.036 cm) coronary angioplasty guidewire and 3 and 4 mm balloon catheters were advanced successively. Subsequently a 0.028" interchange Rosen guide was advanced, gradually introducing balloon catheters up to 8 mm of diameter.
The dilatation with balloon catheter systems of increasing diameter allowed to amplify the stenosis zone, improving arterial oxygen partial pressure and saturation without evidences of left lung hyperflux. Considering the anatomic characteristics of the pulmonary systemic shunt, the use of carrier catheters facilitates the penetration of balloon catheters to the stenosis zone.
Percutaneous transluminal angioplasty may be used with success in patients with stenosis of Blalock-Taussig shunts, independent of the anastomosis curvature and even if the magnitude of the stenosis is significant.
报告一名患有三尖瓣闭锁、肺动脉严重狭窄、左肺-体循环分流狭窄及右体肺分流闭塞的女性患者。
腔内血管成形术已被广泛应用于多种先天性心脏病的治疗，在其中一些疾病中，它是首选的治疗方法。
使用同轴系统扩张肺-体循环分流的远端狭窄，该系统最初由一根带有软头的8F右Judkins输送导管组成，通过该导管依次推进一根0.014英寸（0.036厘米）的冠状动脉成形术导丝以及3毫米和4毫米的球囊导管。随后推进一根0.028英寸的交换Rosen导管，逐渐引入直径达8毫米的球囊导管。
使用直径不断增大的球囊导管系统进行扩张，可扩大狭窄区域，提高动脉血氧分压和饱和度，且未出现左肺血流过多的迹象。考虑到肺-体循环分流的解剖特征，使用输送导管便于球囊导管进入狭窄区域。
经皮腔内血管成形术可成功用于治疗布莱洛克-陶西格分流狭窄的患者，无论吻合口曲率如何，即使狭窄程度严重也适用。
