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目的:探讨应用支架在治疗肺动脉分支狭窄后对右心功能的改善效果。方法:7例患有复杂先天性心脏病外科术后残余肺动脉狭窄的患儿接受了经导管应用支架置入的介入治疗。年龄4~18岁,平均年龄8.7岁,体质量13~56kg,平均28.4kg。结果:法洛四联症(TOF)术后残留左肺动脉或右肺动脉狭窄者6例,矫正型大动脉转位(c TGA)1例,分别置入右肺动脉支架4例,左肺动脉支架3例。随访至1年:支架置入后,肺动脉狭窄处内径明显增加;狭窄处压差(ΔP)较术前明显降低;三尖瓣瓣环收缩位移明显增大,右心室TDI提示右心室收缩舒张功能均明显改善。术后患儿活动耐量增加,心功能分级提高。结论:肺动脉支架置入术目前已成为肺动脉分支狭窄理想治疗方法,可解除狭窄并显著改善右心功能。
Objective: To investigate the effect of stent on right heart function after treatment of pulmonary artery stenosis. METHODS: Seven children with residual pulmonary artery stenosis after complicated surgical treatment of congenital heart disease underwent interventional therapy with a catheterized stent. Aged 4 to 18 years old, with an average age of 8.7 years old, body weight 13 ~ 56kg, an average of 28.4kg. Results: Six cases of residual left pulmonary artery or right pulmonary artery stenosis after TOF and one case of cTAG were placed in the right pulmonary artery stent and the left pulmonary artery stent in 3 cases respectively. Follow-up to 1 year: After stent implantation, the diameter of pulmonary artery stenosis increased significantly; pressure drop at the stenosis (ΔP) was significantly lower than that before operation; tricuspid annulus contractility and displacement significantly increased, right ventricular TDI prompted right ventricular systolic and diastolic function Significantly improved. Children with postoperative activity increased, heart function classification increased. Conclusion: Pulmonary artery stenting has become an ideal treatment for pulmonary artery stenosis, which can relieve stenosis and improve right heart function significantly.