肺動脈閉鎖病人接受瓣膜擴張術擴右心室出口整形治療發育不良之右心室成長之研究
Date Issued
2001
Date
2001
Author(s)
王主科
DOI
892314B002392
Abstract
Between June 1995 and August 2001, 44
neonates with PA/IVS underwent cardiac
catheterization and angiography.
Thirty-seven patients tricuspid valve Z-value
>-4 (ranging from –3.2 to 0.6, mean -1.4
± 0.8) without significant sinusoid
underwent right ventricle decompression in
the neonatal period. Seven patients in whom
decompression of right ventricle was
considered as contraindicated because of
severe hypoplasia of right ventricle tricuspid
valve Z < -4 or sinusoid-coronary
communications were used as controls. Of
the 37 patients, transcatheter pulmonary
valvotomy was attempted in 31 and was
successful in 28 patients: 4 with a guidewire
and 24 with a radiofrequency guidewire.
Mean while, 6 neonates with PA/ IVS
underwent right ventricular outflow tract
reconstruction with or without a shunt. Six
of the 28 patients further required a right
ventricular out flow tract patch, despite an
initial success in pulmonary valvotomy. Of
the 37 patients, there were 3 mortalities.Therefore, a total of 34 patients who
underwent decompression of right ventricle
(14 RVOT patch and 20 transcatheter
valvotomy) were available for follow up. A
total of 34 patients who were discharged
with systemic O2 saturation above 75% were
enrolled in this sutudy. After a follow-up
period ranging from 2 to 62 months, the
mean Z value of tricuspid value measured an
echocardiography increased from –1.7 + 1.2
to –0.8 + 1.3 during follow-up. However, of
the 7 patients managed with a modified B-T
shunt, the Z value of tricuspid valve
remained unchanged. (–3.2 + 0.6 vs. –3.6 +
0.8, P >0.05)
Conclusion:Right ventricle could grow in
PA-IVS patients if patients decompression
could be performed in early infancy.
Subjects
pulmonary atresia and intact
ventricular septum
ventricular septum
transcatheter treatment
right ventr icle
radiofrequency guidewire
Publisher
臺北市:國立臺灣大學醫學院小兒科
Type
report
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