未经证实:先天性门体分流术(CPSS)很少见,并伴有肝性脑病,肺动静脉畸形(PAVMs),肺动脉高压(PH)。
UASSIGNED:本研究的目的是观察经导管封堵CPSS的可行性及其结果。
UNASSIGNED:我们分析了来自五个机构(2013年3月至2019年4月)的24例CPSS患者的数据。基线评估包括超声心动图和气泡对比研究,腹部超声检查,计算机断层扫描血管造影,和CPSS测试球囊闭塞的心脏导管插入术。评估显示12例PAVM,8例PH和2例呼吸窘迫引起的发紫。两个人同时患有紫癜和PH。CPSS完全导管关闭的资格标准包括显示肝内门静脉(PV)自由基以及闭塞时PV压力≤18mmHg。
UNASSIGNED:中位年龄和体重分别为8岁(0.5-21)和19.5公斤(4.2-73),分别。使用各种闭塞装置对21例患者(22例手术)进行了经导管闭合,对一名患者进行了支架移植物排除。鉴于门静脉高压和增生性PVs较高,未进行封堵。在随访期间(中位数:42个月,范围:61天-4.8年),14例PAVM患者的饱和度恢复正常。接受手术的所有八名患者的PH均下降。两名患者的呼吸窘迫得到改善。
UNASSIGNED:CPSS导管闭合的早期和短期随访结果似乎很有希望。然而,进一步,需要随访以证明长期有效性。
UNASSIGNED: Congenital portosystemic shunts (CPSS) are rare and present variably with hepatic encephalopathy, pulmonary arteriovenous malformations (PAVMs), and pulmonary hypertension (PH).
UNASSIGNED: The objective of the study was to see the feasibility of transcatheter closure of CPSS and their outcome.
UNASSIGNED: We analyzed the data of 24 patients of CPSS who underwent transcatheter closure from five institutions (March 2013 to April 2019). Baseline evaluation included echocardiography with bubble contrast study, ultrasound examination of the abdomen, computed tomography angiogram, and cardiac catheterization with test balloon occlusion of the CPSS. The evaluation showed cyanosis due to PAVM in 12, PH in 8, and respiratory distress in 2. Two had both cyanosis and PH. Criteria for eligibility for complete catheter closure of CPSS included demonstration of intrahepatic portal vein (PV) radicals together with a PV pressure of ≤18 mmHg on occlusion.
UNASSIGNED: The median age and weight were 8 years (0.5-21) and 19.5 kg (4.2-73), respectively. Transcatheter closure was performed in 21 patients (22 procedures) using a variety of occlusive devices and stent-graft exclusion was done in one patient. Closure was not done in 3 in view of high portal venous pressures and hypoplastic PVs. During the follow-up (median: 42 months and range: 61 days-4.8 years), saturation normalized in 14 patients with PAVM. PH declined in all eight patients who underwent the procedure. Respiratory distress improved in two patients.
UNASSIGNED: Early and short-term follow-up results of catheter closure of CPSS appear promising. However, further, follow-up is needed to demonstrate long-term effectiveness.