儿童先天性冠状动脉瘘介入治疗32例疗效分析  

Effect analysis of interventional treatment of congenital coronary artery fistula in 32 children

作　　者：王祥[1] 陈智[1] 夏元喜[1] 曾闵[1] 王勋[1] 左超[1] WANG Xiang;CHENG Zhi;XIA Yuanxi;ZENG Min;WANG Xun;ZUO Chao(Department of Cardiology,Children’s Hospital of Hunan Province,Changsha 410007,China)

机构地区：[1]湖南省儿童医院心内科,410007

出　　处：《心肺血管病杂志》2020年第7期790-794,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:总结介入治疗儿童先天性冠状动脉瘘的疗效和经验。方法:对2012年9月至2018年7月,予以经皮介入封堵的儿童冠状动脉瘘患儿32例进行总结,术前经过经胸超声心动图诊断,术后随访并发症,对比手术前后左心室,左心房内径、心胸比以及LVEF变化以及观察术后并发症情况。结果:所有患儿均成功放置封堵器,4例(12.5%)患儿术后1年内存在残余分流;1例患儿术后再次行残余瘘封堵术,1例(3.1%)患儿术后围手术期内存在穿刺部位股静脉血栓,所有患儿未见明显房室传导阻滞并发症发生,随访期间无患儿死亡及其他并发症发生。术后1年经胸超声心动图评估LVEF、LAD、长轴位左心室内径以及胸部X线心胸比较之术前明显减少(P<0.05)。结论:在严格掌握手术指征和禁忌的前提下,经皮介入封堵治疗儿童冠状动脉瘘是安全和有效的。Objective:To summarize the curative effect and experience of the treatment of congenital coronary artery fistula(CAF)in children.Methods:Thirty-two children with CFA who were blocked by percutaneous intervention from September 2012 to July 2018 were summarized.The patients were diagnosed by transthoracic echocardiography before and after surgery,and the complications were followed up after surgery.Changes in left ventricle,left atrium inner diameter,heart ratio and LVEF before and after surgery were compared,as well as postoperative complications were observed.Results:All the children were successfully placed with the device,and 4 cases(12.5%)had residual shunt within 1 year postoperative.One child underwent residual fistula closure again after surgery,and one(3.1%)had femoral vein thrombosis at the puncture site during the perioperative period postoperative.No obvious atrioventricular block complications occurred in all the children,and no death or other complications occurred during follow-up.One year after the operation,there was a significant decrease in LVEF,LAD,long axial left ventricular diameter,and chest X-ray cardiothoracic comparison by transthoracic echocardiography(P<0.05).Conclusions:It is safe and effective to block CAF by percutaneous intervention.

关 键 词：先天性冠状动脉瘘 儿童 介入治疗 

分 类 号：R54[医药卫生—心血管疾病]