危重肺动脉高压右心衰竭患者D-shant心房分流器植入1例报道及文献复习  

D-shant atrial shunt device implantable in patients with severe pulmonary hypertension and right heart failure:one case report and literature review

作　　者：肖书娜 高文洁 尚小珂 张长东 钟禹成[2] 智莹 邱林立 董燕斐 何艳 田卫 唐雯雯 XIAO Shu-na;GAO Wen-jie;SHANG Xiao-ke;ZHANG Chang-dong;ZHONG Yu-cheng;ZHI Ying;QIU Lin-li;DONG Yan-fei;HE Yan;TIAN Wei;TANG Wen-wen(Cardiovascular Center,Liyuan Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 432300,China;Department of Cardiovascular Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 432300,China;Department of Cardiology,Wuhan NO.9 Hospital,Wuhan 432300,China)

机构地区：[1]华中科技大学同济医学院附属梨园医院心血管临床医学中心,湖北武汉432300 [2]华中科技大学同济医院附属协和医院心脏大血管心外科,湖北武汉432300 [3]武汉市第九医院,湖北武汉432300

出　　处：《中国介入心脏病学杂志》2024年第8期472-477,共6页Chinese Journal of Interventional Cardiology

摘　　要：结合病例评价经皮D-shant心房分流器植入在重度肺动脉高压(PAH)右心衰竭患者的安全性及有效性。1例53岁女性患者,诊断重度特发性PAH合并右心衰竭,世界卫生组织心功能分级Ⅳ级,于2021年11月30日在局部麻醉下行右心导管+D-shant心房分流器植入术。术中选择6 mm×4 cm外周动脉球囊扩张房间隔,植入开口直径4 mm D-shant心房分流器,术后患者症状好转,血流动力学改善。姑息性经皮心房分流器植入以建立右向左分流是治疗晚期PAH患者的另一种方法,具有良好的安全性和有效性。或许是目前耐药重度PAH患者改善症状和延长生存期的另一种替代治疗。To evaluate the effectiveness and safety of implantable D-shant atrial shunt device in patients with severe pulmonary arterial hypertension(PAH)and right heart failure.A 53-year-old female patient diagnosed with severe idiopathic PAH and right heart failure,her WHO FC grade wasⅣ.The right heart catheter and implantation of D-shant atrial shunt device were performed under local anesthesia on November 30,2021.A 6 mm×4 cm peripheral artery balloon was selected to dilate the atrial septum and a D-shant atrial shunt device with a fixed 4 mm diameter orifice was implanted into the heart.The clinical symptoms and hemodynamics of the patient was improved after the intervention.Implantation of atrial shunt device as a palliative therapy to established a right to left shunt is another strategy for treating patients with severe PAH in late period,which has good effectiveness and safety.It could be the last replacement therapy to improve symptoms and prolonged lives to drug resistant and severe PAH patients.

关 键 词：肺动脉高压 心房分流器 球囊房间隔造口术 

分 类 号：R54[医药卫生—心血管疾病]