摘要
目的评价新型Pul-Stent支架在姑息性右心室-肺动脉连接术(Sano分流术)后肺动脉狭窄中的临床应用价值。方法纳入2014年8月至2015年6月阜外医院9例肺动脉闭锁合并室间隔缺损行姑息性Sano分流术后肺动脉狭窄的患儿行新型Pul-Stent支架置入术。男5例,女4例;年龄4(1,9)岁;体重9~25(15.1±4.9)kg。结果 9例患儿共成功置入9枚支架,其中3例置入左肺动脉,6例置入右肺动脉。支架置入后,肺动脉狭窄处内径由术前(3.0±1.4)mm增加至(8.8±1.4)mm(P<0.001),跨狭窄处压力阶差由术前(73.2±21.4)mm Hg(1 mmHg=0.133 kPa)降至(36.1±18.8)mm Hg(P<0.001),右心室收缩压/主动脉收缩压比值由术前(0.7±0.2)降为(0.4±0.2)(P<0.001),差异均有统计学意义。术中1例球囊破裂,于外科术中置入肺动脉支架,无其他并发症发生。随访3(3,4)年,肺动脉支架无再狭窄、移位或断裂等,8例(8/9)接受了Ⅱ期根治术。结论新型Pul-Stent支架作为一种专门设计用于肺动脉狭窄的支架,应用于Sano分流术后肺动脉狭窄安全且有效。
Objective To evaluate the clinical value of Pul-stent for pulmonary artery stenosis after palliative right ventricular-pulmonary artery shunt(Sano shunt). Methods From August 2014 to June 2015,9 patients with branch pulmonary artery stenosis after Sano shunt underwent Pul-stent implantation,including 5 males and 4 females. The median age of those patients was 4(1,9)years;the mean weight was(15.1±4.9)kg. Results A total of 9 stents were implanted successfully in 9 patients,including 3 patients of stents in the left pulmonary and 6 in the right pulmonary respectively. The diameter of the narrowest segment improved from(3.0±1.4)mm to(8.8±1.4)mm(P<0.001)and the systolic gradient across the stenosis fell from a median of(73.2±21.4)mm Hg to(36.1±18.8)mm Hg(P<0.001,1 mmHg=0.133 kPa). The right ventricle to aortic pressure ratio fell from(0.7±0.2)to(0.4±0.2)(P<0.001). Complications included one stent expansion incompletely because of balloon burst,the stent was intraoperative implantation,no other complications occurred. Conclusions The results of study preliminarily indicated that as a specially designed for pulmonary artery stenosis stent,Pul-stent applied to postoperative pulmonary artery stenos is safe and effective,whether it can promote the development of pulmonary artery need further confirmed by larger sample.
作者
万俊义
张戈军
潘湘斌
李守军
高华伟
WAN Jun-yi;ZHANG Ge-jun;PAN Xiang-bin;LI Shou-jun;GAO Hua-wei(Department of Structural Heart Disease Center,Cardiovascular Institute and Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing l00037,China)
出处
《中国介入心脏病学杂志》
2019年第9期506-509,共4页
Chinese Journal of Interventional Cardiology
关键词
肺动脉闭锁
肺动脉
狭窄
支架
Pulmonary atresia
Pulmonary artery
Stenosis
Stents
