主动脉缩窄合并动脉导管未闭的介入治疗  

Interventional therapy for coarctation of aorta complicated by patent ductus arteriosus

作　　者：舒茂琴[1] 宋治远[1] 刘建平[1] 何国祥[1] 冉擘力[1] 李永华[1] 庄国强[1] 

机构地区：[1]第三军医大学西南医院心内科重庆市介入心脏病学研究所,重庆400038

出　　处：《重庆医学》2006年第4期300-301,304,共3页Chongqing medicine

基　　金：西南医院临床研究资助项目(SW2004017)

摘　　要：目的 探讨主动脉缩窄（COA）合并动脉导管未闭（PDA）介入治疗新方法。方法 在全麻下完成操作，经12F输送鞘管将一主动脉带膜支架送至COA处，经双球囊扩张定位并置入。结合文献报道，对COA的类型、诊断、治疗及COA合并PDA的介入治疗进行讨论。结果 （1）经双球囊扩张及主动脉带膜支架置入后COA被解除，跨主动脉缩窄处收缩期压力阶差术前为90-96mmHg（1mm Hg=0．133kPa），术后基本消失。（2）术前四肢血压分别为：右上肢165／110mmHg、左上肢160／110mmHg、右下肢未满意测出、左下肢55／35mmHg；术后第3天四肢血压分别为：右上肢100／75mmHg、左上肢105／80mmHg、右下肢110／70mmHg、左下肢115／75mmHg。（3）随访3个月，惠儿血压正常，无并发症发生。结论 先天性COA并PDA患者可用双球囊可扩张性主动脉带膜支架治疗，且安全、有效。Objective To explore a new method of interventional therapy for coarctation of aorta （COA） complicated by patent ductus arteriosus （PDA）. Methods Double balloon-expandable graft-stent implantation was performed through 12 French sheath in a 9-year old child with COA complicated by PDA under general anaesthesia. The COA category, diagnosis, treatment and the interventional therapy of COA complicated by PDA were reviewed. Results （1） COA was relieved undergoing double balloon expandable graft-stent implantation, the trans-coarctation systolic pressure gradients were from 90-96mmHg before intervention to 6-8mm Hg post-operation. （2） The preoperative blood pressures of four limbs were followed as： 165/110mm Hg in right upper limb, 160/110mm Hg in left upper limb, 55/35mHg in left lower extremity, no satisfactory reading in right extremity. The blood pressures at 3d after operation followed as： 100/70mm Hg in right upper limb, 105/80mm Hg in left upper limb, 110/70mm Hg in left lower extremity, 115/75mm Hg in right extremity. （3） This child had normal blood pressures without complications during follow up of 3 months. Conclusion The double balloon expandable graft-stent implantation for patients with COA complicated by PDA might be safe and effective.

关 键 词：主动脉缩窄 动脉导管未闭 经导管治疗 先天性心脏病 

分 类 号：R725.4[医药卫生—儿科]