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El estentamiento de la collateral aortopulmonar en las atresías pulmonares complejas
1Department of Pediatric Cardiology, Royal Brompton Hospital, London, England.
Circulation
|November 15, 1996
Resumen
La colocación de un stent en las colaterales aortopulmonares estenosas ofrece una paliativa efectiva para pacientes seleccionados con atresia pulmonar compleja e hipoxemia. Esta técnica de cardiología intervencionista mejoró la saturación de oxígeno y la capacidad de ejercicio en la mayoría de los pacientes estudiados.
Área de la Ciencia:
- Cardiología Intervencionista Cardiología intervencionista.
- Cardiología Pediátrica Cardiología pediátrica.
- Enfermedad cardíaca congénita.
Sus antecedentes:
- Se debate el tratamiento óptimo para la atresia pulmonar compleja.
- La unifocalización quirúrgica no es universalmente aceptada.
- La corrección biventricular no es factible para todos los pacientes, lo que requiere estrategias paliativas.
Objetivo del estudio:
- Para evaluar la eficacia de la colocación de stents estenóticos colaterales aortopulmonares para la paliación en atresia pulmonar compleja.
- Evaluar las mejoras sintomáticas y fisiológicas en pacientes sometidos a esta intervención.
Principales métodos:
- Doce pacientes con atresia pulmonar compleja e hipoxemia sintomática fueron sometidos a estenting de collateral aortopulmonar esténico.
- Las garantías suministraban al menos tres segmentos pulmonares y eran dilatables por globo.
- El despliegue del stent se intentó en 11 pacientes, con un fracaso para atravesar la estenosis.
Principales resultados:
- Se logró una excelente paliación en la mayoría de los pacientes (10/11).
- La saturación arterial media de oxígeno mejoró significativamente del 64% al 78% (P < .01).
- La duración del ejercicio aumentó temprano después del procedimiento (P < .01), con un paciente que requirió cirugía para un lóbulo casi ocluido y dos que experimentaron desaturación tardía.
Conclusiones:
- El estentamiento de collateral aortopulmonar estenótico proporciona una excelente paliativa para un grupo cuidadosamente seleccionado de pacientes con atresia pulmonar compleja.
- Este enfoque intervencionista puede mejorar significativamente la oxigenación y el estado funcional.
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