Branch pulmonary artery stenosis

分支肺动脉狭窄
  • 文章类型: Case Reports
    背景:弹性蛋白驱动的遗传病是一组由弹性蛋白功能不全和异常蛋白的显性阴性产生驱动的复杂疾病,包括瓣上主动脉瓣狭窄(SVAS)和常染色体显性遗传皮肤松弛。这里,据报道,一个在ELN基因中出现新的无意义突变的中国男孩。
    方法:我们报告了一个1岁男孩,他表现为运动不耐受,体重随年龄增长的限制,有1年的心脏杂音史,还有腹股沟疝.基因测序揭示了ELN基因中的一种新的无义突变(c.757C>T(p。Gln253Ter),NM_000501.4)。由于严重的分支肺动脉狭窄,用自体心包重建分支肺动脉。术后3个月行腹股沟疝修补术。经过6个月的门诊随访,孩子恢复得很好,随着年龄的增长,无特殊临床症状。
    结论:我们在ELN基因中发现了一个导致轻度SVAS和重度分支肺动脉狭窄的从头无义突变。还需要考虑腹股沟疝的新表型,以可能与ELN基因相关。尽管如此,需要进一步确认。
    Elastin-driven genetic diseases are a group of complex diseases driven by elastin protein insufficiency and dominant-negative production of aberrant protein, including supravalvular aortic stenosis (SVAS) and autosomal dominant cutis laxa. Here, a Chinese boy with a novel nonsense mutation in the ELN gene is reported.
    We report a 1-year-old boy who presented with exercise intolerance, weight growth restriction with age, a 1-year history of heart murmur, and inguinal hernia. Gene sequencing revealed a novel nonsense mutation in the ELN gene (c.757 C > T (p.Gln253Ter), NM_000501.4). Due to severe branch pulmonary artery stenosis, the reconstruction of the branch pulmonary artery with autologous pericardium was performed. The inguinal hernia repair was performed 3 months postoperatively. After six months of outpatient follow-up, the child recovered well, gained weight with age, and had no special clinical symptoms.
    We identified a de novo nonsense mutation in the ELN gene leading to mild SVAS and severe branch pulmonary artery stenosis. A new phenotype of inguinal hernia was also needed to be considered for possible association with the ELN gene. Still, further confirmation will be necessary.
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  • 文章类型: Case Reports
    经导管封堵动脉导管未闭(PDA)现已成为护理标准,但有一些例外。儿童外周肺动脉(PA)狭窄的最佳治疗方法仍有争议。手术增强,气球扩张,和支架是可用的选择,每个都有自己的风险和局限性。这里,我们报告了3例先天性风疹综合征患者的完整的经导管治疗,这些患者通过封堵器和支架置入导致PDA和左分支PA狭窄。有两个病例的成功结果和并发症,导致一个手术。我们还分享我们对案例选择的理解,以获得更好的结果。
    Transcatheter closure of patent ductus arteriosus (PDA) is now the standard of care with some exceptions. Best treatment for peripheral pulmonary artery (PA) stenosis in small children is still debatable. Surgical augmentation, balloon dilatation, and stenting are the available options with each having its own risks and limitations. Here, we are reporting complete transcatheter management of three cases of congenital rubella syndrome who had PDA and left branch PA stenosis by device closure and stent placement, with successful outcome in two cases and complication, leading to surgery in one. We also share our understanding of case selection for a better outcome.
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  • 文章类型: Case Reports
    UNASSIGNED: Coronavirus disease 2019 (COVID-19) continues to be a pandemic worldwide. Lung transplantation is the last option to increase life expectancy of end-stage COVID-19 patients. Branch pulmonary artery stenosis (PAS) is a rare complication after lung transplantation with an extremely poor prognosis. The current trend in the management of branch PAS is percutaneous balloon angioplasty and/or stent implantation, rather than high-risk reoperation with a lower success rate.
    UNASSIGNED: The subject was a 54-year-old male with severe acute respiratory syndrome coronavirus 2 infection who underwent a double-lung transplantation. He suffered hypoxaemia and right heart dysfunction following the operation. Right cardiac catheterization and pulmonary angiography examination revealed severe stenosis of the right branch pulmonary artery. Due to immunosuppression and reduced coagulation function, the patient underwent pulmonary artery balloon dilatation and stent implantation, and ultimately recovered well.
    UNASSIGNED: The combination of balloon dilatation and stent implantation is a good alternative to reoperation for patients with COVID-19.
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  • 文章类型: Journal Article
    Stenting of patent ductus arteriosus (PDA) is an attractive alternative to the surgical aortopulmonary shunt in the palliation of cyanotic congenital heart disease. However, the diverse morphology of PDA in this setting limits its role, as stenting an overly tortuous duct may not be feasible, and in a significant number of patients, ductus-related pulmonary artery stenosis contraindicates this procedure. The major acute complications are stent migration, thrombosis, and cardiac failure. Early failure of palliation caused by in-stent stenosis is another limitation of this procedure.
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