体肺动脉侧支血管堵闭术在紫绀型先天性心脏病围术期的应用  

Systemic-to-pulmonary artery collateral vessels in pediatric patients with cyanotic congenital heart disease： treatment by transcatheter embolization

作　　者：谢育梅[1] 张智伟[1] 李渝芬[1] 庄建[2] 陈欣欣[2] 钱明阳[1] 陈寄梅[2] 岑坚正[2] 

机构地区：[1]广东省人民医院心儿科,广州510080 [2]广东省人民医院小儿心外科,广州510080

出　　处：《中华胸心血管外科杂志》2007年第2期94-96,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的评价经皮体肺动脉侧支血管堵闭术在伴有右室流出道或肺动脉梗阻的紫绀型先天性心脏病病儿围手术期应用的效果。方法2005年5月至2006年6月,共11例紫绀型先天性心脏病病儿分别选用弹簧圈和血管塞行经皮体-肺侧支血管堵闭术,7例于外科矫治手术前行侧支血管的堵闭,4例于术后进行介入治疗。结果共堵闭侧支血管19条;6例堵闭单条、5例同时堵闭多条侧支。术后造影显示14条侧支（74％）分流基本消失,5条（26％）大部分堵闭。结论在外科手术前或术后反复心、肺功能不全的病儿,进行体肺侧支血管的堵闭治疗是安全、有效的,有利于渡过围手术期,提高手术成功率,改善手术效果。Objective Systemic-to-pulmonary collateral vessels can develop in patients with obstruction of the fight ventricular outflow tract or the pulmonary artery. Occlusion of these vessels is necessary before or after surgical correction of the primary disease. Methods Between May 2005 and June 2006, transcatheter occlusion of aortopulmonary collateral vessels was performed in 11 pediatric patients with congenital heart disease. Patients ranged in age from 5 month to 16 years and in weight from d.5 to 46.0 kg. Cook coils and Amplatzer plugs were used to be occluded 19 vessels in 11 patients. In seven patients, occlusion was performed before surgery and in four after surgical correction. Results Procedure resulted in total occlusion in 14（74% ） and subtotal（26% ） in 5 of the target vessels. A single vessel was occluded in six patients and multiple vessels in five patients. A coil migrated to the right pulmonary artery in one patient. The coil was removed nonsurgically by a snare and occlusion with another size of coil was performed without further complication. Condnslon The results demonstrate that transcatheter occlusion can be an effective procedure for managing systemic-to-pulmonary vessels in children with congenital heart disease.

关 键 词：心脏缺损 先天性 侧支循环 栓塞 治疗性 

分 类 号：R686[医药卫生—骨科学]