Rey C, Godart F, Coullet J M, Cajot M A, Bel-Méallier V, Beregi J P, Brevière G M, Vaksmann G, Francart C
Service de cardiologie infantile, hôpital cardiologique, CHRU de Lille.
Arch Mal Coeur Vaiss. 1996 May;89(5):517-23.
Between July 1992 and October 1995. 10 Palmaz stents were implanted in 6 patients aged 2 to 25 years with stenoses of pulmonary artery branches. The stenoses were located on the right (n = 2) or left pulmonary artery (n = 3) or both branches (n = 1). Stenoses of the right pulmonary artery were secondary to a Waterston (n = 1) or Blalock-Taussig (n = 1) anastomosis or to surgical plasty with Dacron (n = 1). Stenoses of the left pulmonary artery were secondary to surgical plasty with Goretex (n = 2), pericardium (n = 1) or Dacron (n = 1): three of these patients had undergone a left Blalock-Taussig anastomosis before complete correction. After implantation of the stent, the pulmonary artery diameter increased from 4 +/- 2 mm to 11 +/- 2 mm (p = 0.0117) and the transstenotic gradient decreased from 44 +/- 18 to 15 +/- 12 mmHg (p = 0.0277). Similarly, the percentage of homolateral pulmonary perfusion at scintigraphy increased from 22 +/- 13% to 53 +/- 17% (p = 0.0431). There were no deaths. The major complication was migration of the stent, observed in three patients at the moment of implantation in two cases and in the hours following implantation in the other case. In these 3 patients, the embolised stent was left in the pulmonary arteries with no adverse consequences on pulmonary perfusion. Two of these patients later successfully underwent further catheterisation for implantation of another stent. Implantation of a stent is a therapeutic alternative in pulmonary artery stenoses which often recur after surgery and/or angioplasty. They increase the diameter of the stenosed vessel and reestablish the equilibrium of perfusion between the two lungs.
1992年7月至1995年10月期间，对6例年龄在2至25岁的肺动脉分支狭窄患者植入了10枚帕尔马兹支架。狭窄位于右肺动脉（2例）、左肺动脉（3例）或双侧分支（1例）。右肺动脉狭窄继发于沃特斯顿吻合术（1例）、布劳洛克 - 陶西格吻合术（1例）或涤纶片修补术（1例）。左肺动脉狭窄继发于戈尔特斯修补术（2例）、心包修补术（1例）或涤纶片修补术（1例）：其中3例患者在完全矫正前接受过左布劳洛克 - 陶西格吻合术。植入支架后，肺动脉直径从4±2毫米增加到11±2毫米（p = 0.0117），跨狭窄压差从44±18毫米汞柱降至15±12毫米汞柱（p = 0.0277）。同样，闪烁扫描时同侧肺灌注百分比从22±13%增加到53±17%（p = 0.0431）。无死亡病例。主要并发症是支架移位，2例在植入时、1例在植入后数小时观察到。在这3例患者中，栓塞的支架留在肺动脉内，对肺灌注无不良影响。其中2例患者后来成功接受了再次导管介入植入另一枚支架。支架植入是肺动脉狭窄的一种治疗选择，肺动脉狭窄在手术和/或血管成形术后常复发。它们增加了狭窄血管的直径，并重建了两肺之间的灌注平衡。
