PDF(Pubmed)
Abstract：
UNASSIGNED: Restriction of PBF in infants born with CHD is often required to avoid pulmonary over-circulation prior to definitive intervention. The current standard is to surgically place pulmonary artery bands, but these have limitations and are associated with complications.
UNASSIGNED: The purpose of this study was to a single-center experience with a relatively novel technique to percutaneously restrict pulmonary blood flow (PBF) in select infants with congenital heart disease (CHD).
UNASSIGNED: Patients were selected to undergo this procedure either due to low birth weight or prematurity. All of them had CHD that would result in over-circulation without control of PBF. By a percutaneous method, modified vascular plug devices were placed in the bilateral branch pulmonary arteries.
UNASSIGNED: Seven neonates with CHD resulting in left-sided obstruction underwent this procedure. All patients demonstrated evidence of restricted PBF with a decrease in mean oxygen saturation from 95% to 84%. One patient required pulmonary artery band placement due to over-circulation 5 days after the procedure. All patients proceeded to full surgical intervention without device embolization or need for pulmonary arterioplasty. Hemodynamics demonstrated adequate limitation of PBF in 5 patients who underwent presurgical cardiac catheterization with a mean pulmonary vascular resistance of 1.52 WU × m2 and a mean transpulmonary gradient of 5.9 mm Hg.
UNASSIGNED: Percutaneous PBF restriction appears to be safe and a less invasive option to delay surgical intervention in a select population to allow for somatic growth and gestational maturation. It results in a decrease in the total number of sternotomies.
UNASSIGNED: The purpose of this study was to a single-center experience with a relatively novel technique to percutaneously restrict pulmonary blood flow (PBF) in select infants with congenital heart disease (CHD).
UNASSIGNED: Patients were selected to undergo this procedure either due to low birth weight or prematurity. All of them had CHD that would result in over-circulation without control of PBF. By a percutaneous method, modified vascular plug devices were placed in the bilateral branch pulmonary arteries.
UNASSIGNED: Seven neonates with CHD resulting in left-sided obstruction underwent this procedure. All patients demonstrated evidence of restricted PBF with a decrease in mean oxygen saturation from 95% to 84%. One patient required pulmonary artery band placement due to over-circulation 5 days after the procedure. All patients proceeded to full surgical intervention without device embolization or need for pulmonary arterioplasty. Hemodynamics demonstrated adequate limitation of PBF in 5 patients who underwent presurgical cardiac catheterization with a mean pulmonary vascular resistance of 1.52 WU × m2 and a mean transpulmonary gradient of 5.9 mm Hg.
UNASSIGNED: Percutaneous PBF restriction appears to be safe and a less invasive option to delay surgical intervention in a select population to allow for somatic growth and gestational maturation. It results in a decrease in the total number of sternotomies.
摘要：
■在明确干预之前，通常需要在CHD出生的婴儿中限制PBF以避免肺过度循环。目前的标准是手术放置肺动脉带，但这些都有局限性，并与并发症有关。
■这项研究的目的是通过一种相对新颖的技术来对先天性心脏病（CHD）的部分婴儿进行经皮限制肺血流（PBF）的单中心体验。
■由于出生体重不足或早产，选择患者进行此手术。他们都患有CHD，在没有PBF控制的情况下会导致过度循环。通过经皮方法，将改良的血管塞装置放置在双侧分支肺动脉中。
■7例CHD导致左侧梗阻的新生儿接受了该手术。所有患者均表现出限制性PBF的证据，平均氧饱和度从95％降低至84％。一名患者在手术后5天由于过度循环而需要放置肺动脉带。所有患者都进行了全面的手术干预，没有设备栓塞或需要进行肺动脉成形术。血流动力学表明，在5例接受术前心导管插入术的患者中，PBF的局限性足够大，平均肺血管阻力为1.52WU×m2，平均经肺梯度为5.9mmHg。
■经皮PBF限制似乎是安全的，并且是一种侵入性较小的选择，可以延迟选定人群的手术干预以允许体细胞生长和妊娠成熟。它导致胸骨的总数减少。
■这项研究的目的是通过一种相对新颖的技术来对先天性心脏病（CHD）的部分婴儿进行经皮限制肺血流（PBF）的单中心体验。
■由于出生体重不足或早产，选择患者进行此手术。他们都患有CHD，在没有PBF控制的情况下会导致过度循环。通过经皮方法，将改良的血管塞装置放置在双侧分支肺动脉中。
■7例CHD导致左侧梗阻的新生儿接受了该手术。所有患者均表现出限制性PBF的证据，平均氧饱和度从95％降低至84％。一名患者在手术后5天由于过度循环而需要放置肺动脉带。所有患者都进行了全面的手术干预，没有设备栓塞或需要进行肺动脉成形术。血流动力学表明，在5例接受术前心导管插入术的患者中，PBF的局限性足够大，平均肺血管阻力为1.52WU×m2，平均经肺梯度为5.9mmHg。
■经皮PBF限制似乎是安全的，并且是一种侵入性较小的选择，可以延迟选定人群的手术干预以允许体细胞生长和妊娠成熟。它导致胸骨的总数减少。
