Stepwise Treatment for Heterotaxy Syndrome and Functional Single Ventricle Complicated by Infra-Cardiac Total Anomalous Pulmonary Venous Connection with Ductus Venosus Stent Placement and Subsequent Occlusion
Stepwise Treatment for Heterotaxy Syndrome and Functional Single Ventricle Complicated by Infra-Cardiac Total Anomalous Pulmonary Venous Connection with Ductus Venosus Stent Placement and Subsequent Occlusion
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心下完全异常肺静脉连接并发静脉导管支架置入及随后闭塞的异位综合征和功能性单心室的逐步治疗
DOI：
10.1007/s00246-021-02782-z
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发表时间：
2022
影响因子：
1.6
通讯作者：
Kasahara S
中科院分区：
文献类型：
--
作者：
Imai Y;Baba K;Otsuki S;Kondo M;Eitoku T;Shigemitsu Y;Fukushima Y;Hirai K;Iwasaki T;Kanazawa T;Kotani Y;Kasahara S
即使在新生儿期先天性心脏病的手术治疗效果得到改善的今天，异位综合征和功能性单心室合并完全性肺静脉异位连接（TAPVC）的预后，特别是心下型，仍然是灾难性的。我们描述了TAPVC修复后经皮静脉导管（DV）支架置入和闭塞相结合的策略，以确保从初次手术到双向腔静脉分流术（BCPS）的生存率，并促进后续治疗。回顾性研究了三例连续的异位综合征和功能性单心室合并心下TAPVC的患者，采用我们自己的策略进行治疗。在两名婴儿中，在出生当天进行了DV支架置入。1例为11天龄。降低了肺静脉阻塞的风险，并在备用基础上进行了体外循环手术，包括TAPVC修复术。由于所有病例的肝酶均在术后第0至1天迅速升高，因此进行经皮支架封堵直至术后第3天。手术改善了肝功能。1例患者因严重房室瓣返流死亡，1例患者接受了BCPS，1例患者等待接受BCPS。DV支架置入可避免新生儿早期TAPVC修复。TAPVC修复后，门体分流仍然存在，导致肝功能障碍，但这可以通过支架和垂直静脉闭塞得到改善。一系列的逐步治疗可以帮助这些危重婴儿度过高危新生儿期，并实现良好的BCPS循环。
Even today, when the surgical outcome of congenital heart disease in the neonatal period has improved, the prognosis for heterotaxy syndrome and functional single ventricle complicated with total anomalous pulmonary venous connection (TAPVC), especially the infra-cardiac type, is catastrophic. We describe a strategy that combines percutaneous ductus venosus (DV) stent placement and occlusion after TAPVC repair to ensure survival from initial surgery to bidirectional cavopulmonary shunt (BCPS) procedure and facilitate subsequent treatment. Three consecutive patients with heterotaxy syndrome and functional single ventricle complicated by infra-cardiac TAPVC treated with our own strategy were retrospectively studied. In two infants, DV stent placement was performed on the day of birth. In one case at 11 days of age. The risk of pulmonary vein obstruction was reduced, and on-pump surgery, including TAPVC repair, was performed on a standby basis. Since the rapid increase in hepatic enzymes occurred on postoperative day 0 to 1 in all cases, percutaneous stent occlusion was performed until postoperative day 3. The procedure improved liver function. One patient died due to severe atrioventricular valve regurgitation, one case underwent BCPS, and one patient was waiting to undergo. DV stent placement can avoid TAPVC repair in the early neonatal period. After TAPVC repair, the portosystemic shunt remained, resulting in hepatic dysfunction, but this could be improved by stent and vertical vein occlusion. A series of stepwise treatments can be useful to help such critically ill infants survive the high-risk neonatal period and achieve good BCPS circulation.
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成功对2例新生儿无脾综合征并发心下型完全性肺静脉异位引流进行静脉导管支架置入术。
影响因子：
--
作者：
T. Higaki;Eiichi Yamamoto;Takeshi Nakano;Masaaki Ohta;Hidemi Takata;Kikuko Murao;Toshiyuki Chisaka;T. Moritani;M. Nagashima;F. Shikata;E. Ishii
通讯作者：
E. Ishii
影响因子：
1.9
作者：
Poeppelman RS;Tobias JD
通讯作者：
Tobias JD
针对与右心房异构相关的阻塞性混合型完全异常肺静脉连接的初次姑息性支架置入术。
影响因子：
2.1
作者：
M. Kitano;S. Yazaki;K. Kagisaki;K. Kurosaki
通讯作者：
K. Kurosaki
60例婴儿完全性肺静脉异位引流肺血管疾病的定量分析
影响因子：
6
作者：
S. Yamaki;Minora Tsunemoto;M. Shimada;R. Ishizawa;M. Endo;Shingo Nakayama;Masaki Hata;H. Mohri
通讯作者：
H. Mohri
先天性心脏缺陷手术：斯塔克/先天性心脏缺陷手术，第三版
DOI：
10.1002/0470093188
发表时间：
2006
期刊：
影响因子：
--
作者：
J. Stark;M. Leval;V. Tsang
通讯作者：
V. Tsang