先天性心脏病单心室生理双向Glenn手术后的经皮介入治疗  

Transcatheter interventions after bidirectional Glenn shunt in congenital heart disease with single ventricular physiology

作　　者：凌雁[1] 郭保静[1] 张陈[1] 顾虹[1] 戴辰晨[1] 李强强[1] 金梅[1] 刘迎龙[1] 

机构地区：[1]首都医科大学附属北京安贞医院 北京市心肺血管病研究所小儿心脏科,100029

出　　处：《中华胸心血管外科杂志》2014年第4期206-209,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的 探讨通过多种介入治疗方法,优化单心室生理双向Glenn手术后的治疗效果.方法 对22例单心室行双向腔静脉-肺动脉吻合术（双向Glenn手术）后患儿（者）,选择性行经皮主-肺动脉侧支栓堵术、体静脉侧支栓堵术和/或肺动脉球囊扩张术等介入治疗.结果 22例接受介入治疗,男16例,女6例;年龄3.3～18.9岁,平均（9.3±4.2）岁;体质量13～54 kg,平均（29±13） kg.双向Glenn术后（3.1±3.8）年行介入治疗.栓堵主-肺动脉侧支12例,封堵奇静脉和/或半奇静脉11例,肺动脉球囊扩张6例;6例同时行两种介入治疗.介入治疗后9例行全腔静脉-肺动脉连接术,7例正等待Fontan手术,6例暂不宜行Fontan手术者仍随访中,临床状态稳定.结论 单心室行双向Glenn术后,通过个体化的经皮介入治疗方案,可优化治疗效果,为下一步治疗创造条件.Objective To summarize the preliminary results of transcatheter interventions in patients after bidirectional Glenn shunt（BGS） in single ventricular physiology.Methods In patients with single ventricular physiology after bidirectional Glenn shunt,transcatheter occlusion of aortopulmonary collateral arteries,closure of dilated azygous or /and hemiazygousveins,or/and balloon-dilation of pulmonary artery were selected to undertake,according to their clinical and catheterizational profiles.Results 22 patients aged（9.3 ±4.2） years（3.3-18.9 years）,weighted（29 ±13） kg（13-54 kg）,（3.1 ±3.8） years（1.0-12.5 years） after bidirectional Glenn shunt,received transcatheter interventions,including occlusion of aortopulmonary collateral arteries in 12 patients,closure of dilated azygous or/and hemiazygous veins in 11 cases,balloon-dilation of stenotic pulmonary arteries in 6 patients.Native pulmonary artery was dilated in 4 cases.The origin of the stenosed left pulmonary artery were dilated in another 2 patients.6 patients had received two kinds of interventions.After these transcatheter interventions,9 cases had received Fontan procedures uneventfully,7 cases were waiting for Fontan operation,and 6 cases presently not suitable for Fontan were closely followed-up with stable cardiac function and saturation of oxygen unchanged.Conclusion In patients with single ventricular physiology after bidirectional Glenn,individualized transcatheterly interventions can improve clinical results,and make condition for the Fontan operation.

关 键 词：单心室 双向GLENN手术 经皮介入治疗 体-肺侧支动脉 体静脉侧支 肺动脉球囊 

分 类 号：R726.5[医药卫生—儿科]