■在单心室心脏缺陷和导管依赖性肺血流量(ddPBF)的新生儿中使用体肺分流(SPS)在我们中心的历史上与高发病率和死亡率相关。因此,在可行的情况下,我们过渡到优先使用动脉导管支架(DS)。本报告描述了我们使用此策略的初步结果。
■对2015年至2019年接受DS或SPS的单心室患者进行了一项单中心研究,以评估DS是否与降低院内发病率和增加至II期缓解的生存率相关。
■共纳入34例患者(DS=11;SPS=23)。两组间潜在的心脏异常相似,包括肺动脉闭锁,不平衡房室间隔缺损,和三尖瓣闭锁.两组之间的手术成功率相似(82%vs83%)。两名DS患者转换为SPS,由于导管血管痉挛或肺动脉阻塞,四名SPS患者需要手术分流翻修。在DS患者中,术后机械通气持续时间较短(1天vs3天,P=.009)和较少的术后所需的体外膜氧合(9%vs39%,P=.11)。DS患者存活到II期缓解的比例更高(100%vs64%,P=.035),DS患者的一年生存率更高(100%vs61%,P=.02)。
■在我们的中心,与SPS相比,接受DS治疗的单心室心脏缺损和ddPBF患者的院内发病率降低,至II期缓解期生存率提高.
UNASSIGNED: The use of systemic-to-pulmonary shunts (SPS) in neonates with single ventricle heart defects and ductal-dependent pulmonary blood flow (ddPBF) was historically associated with high morbidity and mortality at our center. As a result, we transitioned to the preferential use of ductus arteriosus stents (DS) when feasible. This report describes our initial results with this strategy.
UNASSIGNED: A single-center study of single ventricle patients that received DS or SPS from 2015 to 2019 was performed to assess whether DS was associated with decreased in-hospital morbidity and increased survival to stage II palliation.
UNASSIGNED: A total of 34 patients were included (DS = 11; SPS = 23). Underlying cardiac anomalies were similar between groups and included pulmonary atresia, unbalanced atrioventricular septal defect, and tricuspid atresia. Procedure success was similar between groups (82% vs 83%). Two DS patients were converted to SPS, due to ductal vasospasm or pulmonary artery obstruction, and four SPS patients required surgical shunt revision. In DS patients, postprocedure mechanical ventilation duration was shorter (one vs three days, P = .009) and fewer required postprocedure extracorporeal membrane oxygenation (9% vs 39%, P = .11). A higher proportion of DS patients survived to stage II palliation (100% vs 64%, P = .035), and the probability of one-year survival was higher in DS patients (100% vs 61%, P = .02).
UNASSIGNED: At our center, patients with single ventricle heart defects and ddPBF that received DS experienced reduced in-hospital morbidity and increased survival to stage II palliation compared to SPS.