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目的:评价Cheatham-Platinum(CP)支架治疗儿童主动脉缩窄的早中期疗效。方法:对14例主动脉缩窄(coarctation of the aorta,CoA)儿童行CP支架置入术,其中男性8例,女性6例;年龄4~14岁(中位年龄11岁);体质量19.9~60kg(中位体质量38.2kg)。6例(43%)为未经治疗CoA;8例(57%)为再狭窄CoA。收集和分析CP支架置入前后的数据和随访资料。结果:14例患儿均成功置入CP支架,其中6例裸支架,8例覆膜支架。术后即刻CoA最窄处直径由(6.45±1.39)mm增加至(11.79±1.59)mm,P<0.001;CoA/Dao比由0.41±0.12增加至0.74±0.10,P<0.001;导管测得跨狭窄压差由[(34.86±17.48)mmHg(1mmHg=0.133kPa),下降至(1.64±1.64)mmHg,P<0.001];心脏超声测得跨狭窄压差由[(59.76±15.92)mmHg,下降至(23.89±7.30)mmHg,P<0.001];上肢收缩压由[(142.07±28.95)mmHg降为(124.79±25.92)mmHg,P<0.001];下肢收缩压由[(105.21±21.35)mmHg升为(122.29±25.29)mmHg,P<0.05]。未见主动脉瘤和主动脉夹层的发生。1例患儿术中发生髂动脉内膜撕脱导致术后死亡。随访结果未见再狭窄,未见支架的移位断裂。结论:CP支架治疗儿童CoA早中期疗效好,但远期效果尚需进一步的随访和更多病例的研究。
OBJECTIVE: To evaluate the early and mid-term efficacy of Cheatham-Platinum (CP) scaffold in the treatment of children with aortic constriction. Methods: Fourteen cases of coarctation of the aorta (CoA) were treated with CP stenting, including 8 males and 6 females, aged from 4 to 14 years (median age 11 years), body weight 19.9 ~ 60kg (median body weight 38.2kg). 6 (43%) were untreated CoA; 8 (57%) were CoA restenosis. Data and follow-up data were collected and analyzed before and after CP stent placement. Results: All 14 cases were successfully treated with CP stent, including 6 cases of bare stent and 8 cases of stent graft. The diameter of the narrowest point of CoA increased from (6.45 ± 1.39) mm to (11.79 ± 1.59) mm, P <0.001, and the ratio of CoA / Dao increased from 0.41 ± 0.12 to 0.74 ± 0.10, P <0.001 The stenosis pressure decreased from [(34.86 ± 17.48) mmHg (1mmHg = 0.133kPa) to (1.64 ± 1.64) mmHg, P <0.001] To (23.89 ± 7.30) mmHg, P <0.001]. The systolic blood pressure of upper limb decreased from (142.07 ± 28.95) mmHg to (124.79 ± 25.92) mmHg, P <0.001] (122.29 ± 25.29) mmHg, P <0.05]. No aortic aneurysm and aortic dissection occurred. A case of iliac artery intimal avulsion occurred during surgery led to postoperative death. No restenosis was found in the follow-up results, and no dislocation of the stent was found. Conclusion: The effect of CP scaffold in the early and mid-term treatment of children with CoA is good, but the long-term effect needs further follow-up and more case studies.