Schranz D, Michel-Behnke I, Schmid F X, Oelert H
Kinderkardiologie, Universitätskinderklinik, Mainz.
Z Kardiol. 1996 Jul;85(7):477-81.
Two young adults, 16 and 18 years of age were admitted with complete occlusion of the superior vena cava pathway following previous Mustard procedure. In both patients, perforation of complete occluded vein segment using a straight guidewire and subsequent sequential enlargement by balloon dilation were successfully performed by a left subclavian vein approach. Implantation of a 30 mm Palmaz-stent resulted in a widely patent channel of the vena cava superior into the systemic venous atrium. In short-term follow-up of 3 months both stents remained patent. Repeat dilation of the stents was performed after 3 months. A third patient with systemic venous obstruction was a 3-year old child who suffered low cardiac output following modified Fontan operation caused by a narrowing of the superior vena cava to right pulmonary artery connection and stenosis of distal left pulmonary artery. The severe hemodynamic problem was resolved by implantation of Palmaz-stents in the two separate obstructions. At recatheterization 6 months later, both stents were patent without any residual pressure gradient.
两名分别为16岁和18岁的年轻成人，在先前接受Mustard手术后出现上腔静脉通路完全闭塞而入院。在这两名患者中，通过左锁骨下静脉途径，使用直导丝成功穿刺完全闭塞的静脉段，并随后通过球囊扩张进行序贯扩张。植入一枚30mm的Palmaz支架后，上腔静脉至体静脉心房形成了一个广泛通畅的通道。在3个月的短期随访中，两个支架均保持通畅。3个月后对支架进行了再次扩张。第三名患有体静脉梗阻的患者是一名3岁儿童，在改良Fontan手术后因上腔静脉至右肺动脉连接狭窄和左肺动脉远端狭窄而出现低心输出量。通过在两个单独的梗阻部位植入Palmaz支架，严重的血流动力学问题得到了解决。6个月后再次导管检查时，两个支架均通畅，没有任何残余压力梯度。
