經由主動脈至肺動脈分流管以氣球導管擴張肺動脈瓣膜閉鎖病人之肺動脈狹窄之效果評估
Date Issued
2000
Date
2000
Author(s)
王主科
DOI
892314B002038
Abstract
Objectives. The results of percutaneous
balloon angioplasty for obstructed modified
Blalock-Taussig (BT) or central shunts and
pulmonary artery stenoses were studied to
assess its role as an alternative to second
shunt and surgical pulmonary artery
angioplasty.
Background. Obstruction of a modified shunt
and pulmonary artery stenosis related to the
shunt or ductus is not infrequent. A second
shunt with or without pulmonary artery
angioplasty is required if the pulmonary
artery size, morphology or age of the patient
is suboptimal for definitive surgery.
Methods. From June 1994 to May 1999,
balloon angioplasty for obstructed systemicto-
pulmonary artery shunts was performed in
46 patients, with ages ranging from 1 month
to 7.4 years (2.2±1.9 years). Among the 46
patients, 32 had a modified BT shunt, 5 had
bilateral shunts, 7 had a modified central
shunt and 2 had both modified BT and central
shunt. Stenoses were seen in 27 main branch
pulmonary arteries and interruption was
present in 3. A concurrent balloon
angioplasty was attempted in 28 main branch
pulmonary arteries, but performed in 25
vessels.
Results. Balloon dilation for obstructed
modified shunts was considered to be
effective in 42 patients (91%), while
angioplasty for pulmonary artery stenosis was
effective in 14 vessels, and non-effective in
11 vessels. After balloon dilatation
angioplasty, oxygen saturation in the aorta
increased from 74.4+4.3% to 80.8+3.6%
(P<0.01) in these 42 patients. One patient
died of pneumonia. Eight patients required an
additional modified BT shunt soon after the
procedure because of severe stenosis or
interruption at main branch pulmonary artery.
After a mean follow-up period of 11.6±5.4
months, 29 patients underwent a repeated
imaging study to evaluate the morphology
and size of the pulmonary arteries. Of these 29 patients, 26 underwent open heart surgery
with 2 mortalities.
Conclusions. When a second shunt is under
consideration because of obstruction of the
modified shunt, balloon angioplasty is a
possible alternative procedure. Pulmonary
artery stenosis, if present, can be
simultaneously dilated.
Subjects
modified systemicpulmonary
ar tery shunt
ar tery shunt
pulmonary ar tery stenosis
balloon angioplasty
polytetrafluoroethylene
(PTFE) tube
(PTFE) tube
Publisher
臺北市：國立臺灣大學醫學院小兒科
Type
report
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