USE OF ENDOVASCULAR STENTS IN CONGENITAL HEART-DISEASE
USE OF ENDOVASCULAR STENTS IN CONGENITAL HEART-DISEASE
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DOI：
10.1161/01.cir.83.6.1923
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发表时间：
1991-06-01
期刊：
影响因子：
37.8
通讯作者：
MULLINS, CE
中科院分区：
文献类型：
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作者：
OLAUGHLIN, MP;PERRY, SB;MULLINS, CE
背景 球囊可扩张血管内支架已用于支撑成人冠状动脉和外周动脉中的血管壁。 本研究的目的是检查这些支架治疗先天性心脏病的有效性和安全性。方法和结果。 30例患者置入45枚支架，年龄0.2-30.2岁（体重3.5-76 kg）。 选择狭窄区域难以手术入路的患者。 将支架安装在球囊上并通过标准导管插入技术放置。 分支肺动脉狭窄23例。 成功置入36枚支架，压差从50.6 +/- 24 mm Hg降至15.9 +/- 13.4 mm Hg。 5例患者在心房手术后置入支架：3例在阻塞性Fontan修复术中，1例在窦静脉缺损修复术后的上级腔静脉-右心房交界处，1例在Glenn分流术部位。 心房支架将压差从9.8 +/- 8.2降至2.0 +/- 2.6 mm Hg。 1例患者在缩窄扩张后在降主动脉置入支架，压力梯度从50 mm Hg降至25 mm Hg。 1例患者植入支架后出现肺静脉扩张。 2枚支架在置入时发生移位; 1枚需要手术取出，1枚通过球囊扩张锚定到位。 1名患者在导管插入术后24小时内死亡，原因是Fontan修复术的血栓阻塞。 9名患者接受了再导管插入术。 所有支架置入血管的口径与初始支架置入时相同。 我们的结论是，球囊扩张支架在先天性心脏病的选定术后狭窄中是有用的。
Background. Balloon expandable intravascular stents have been used to support vessel walls in coronary and peripheral arteries in adults. The purpose of this study was to examine the efficacy and safety of these stents in the treatment of congenital heart disease.Methods and Results. Forty-five stents were placed in 30 patients, who were 0.2-30.2 years old (weight, 3.5-76 kg). Patients with areas of stenosis that were difficult to approach surgically were chosen. Stents were mounted over balloons and placed by standard catheterization techniques. Twenty-three patients had branch pulmonary artery stenosis. Thirty-six stents were placed successfully and had reduced pressure gradients from 50.6 +/- 24 to 15.9 +/- 13.4 mm Hg. Five patients had stents placed after atrial surgery: three in obstructed Fontan repairs, one at the superior vena cava-right atrial junction after sinus venous defect repair, and one at the site of a Glenn shunt. Atrial stents reduced pressure gradients from 9.8 +/- 8.2 to 2.0 +/- 2.6 mm Hg. One patient had a stent placed in the descending aorta after coarctation dilation, and the pressure gradient was reduced from 50 to 25 mm Hg. One patient had pulmonary vein dilation with stent placement. Two stents migrated at the time of placement; one required surgical removal, and one was anchored in place by balloon dilation. One patient died within 24 hours of catheterization because of thrombus obstruction of the Fontan repair. Nine patients have undergone recatheterization. All stented vessels have remained at the same caliber as at original stent placement.Conclusions. We concluded that balloon expandable stents are useful in selected postoperative stenoses in congenital heart disease.