Hijazi Z M, Abu Ata I, Kuhn M A, Cheatham J P, Latson L, Geggel R L
Department of Pediatrics, Floating Hospital for Children, Boston, Massachusetts, USA.
Cathet Cardiovasc Diagn. 1997 Feb;40(2):187-90; discussion 191. doi: 10.1002/(sici)1097-0304(199702)40:2<187::aid-ccd17>3.0.co;2-o.
Balloon atrial septostomy remains an important interventional procedure in the pediatric age group. The incidence of potential complications using the conventional balloon ranges from 0-11%. The purpose of this study was to evaluate a new low-profile end-hole septostomy balloon catheter with dual lumen, inserted via a 5F or 6F sheath. Seventeen neonates and infants with various forms of congenital heart disease requiring palliation underwent septostomy using the new catheter at a median age of 19 days (with a range of 1-593 days), and a median weight of 3.4 kg (a range of 2.5-8.4 kg). The aortic saturation increased from 72 +/- 20% to 87 +/- 7%, p < .001; and the gradient across the atrial septum decreased (a-wave gradient from 11.2 +/- 10.3 to 2.1 +/- 3.6 mm Hg; v-wave from 10.4 +/- 7.7 to 1.2 +/- 1.2 mm Hg; and mean gradient from 8.5 +/- 6.9 to 0.9 +/- 1.3 mm Hg, p < .002). The diameter of the defect increased from 2.7 +/- 1.7 mm to 8 +/- 2.3 mm, p < .001. There were no complications. We conclude that this new low-profile septostomy catheter is safe and effective in creating a large defect size between the atria. Because of the smaller inflation size of the balloon and smaller introducer sheath compared with the conventional catheter, this new septostomy catheter should be especially useful in small neonates.
球囊房间隔造口术仍是儿科年龄组一项重要的介入手术。使用传统球囊时潜在并发症的发生率为0%-11%。本研究的目的是评估一种新型的双腔低轮廓端孔造口术球囊导管，该导管通过5F或6F鞘插入。17例患有各种形式先天性心脏病需要姑息治疗的新生儿和婴儿接受了使用这种新导管的房间隔造口术，中位年龄为19天（范围为1-593天），中位体重为3.4kg（范围为2.5-8.4kg）。主动脉血氧饱和度从72±20%升至87±7%，p<0.001；房间隔压差降低（a波压差从11.2±10.3降至2.1±3.6mmHg；v波压差从10.4±7.7降至1.2±1.2mmHg；平均压差从8.5±6.9降至0.9±1.3mmHg，p<0.002）。缺损直径从2.7±1.7mm增加到8±2.3mm，p<0.001。无并发症发生。我们得出结论，这种新型低轮廓造口术导管在心房之间形成大的缺损尺寸方面是安全有效的。由于与传统导管相比，球囊的充盈尺寸更小，导入鞘更细，这种新型造口术导管对小新生儿尤其有用。
