芬坦息后患者的例行监测:从心脏导管学到的经验教训
Maria Victoria Ordonez1,2, Giovanni Biglino1,3, Radwa Bedair2
1Bristol Medical School, University of Bristol, Bristol, UK.
Journal of congenital cardiology
|January 13, 2025
概括
诊断性心脏导管治疗显著改变了Fontan患者的治疗方法,这些患者的症状包括阴症或呼吸障碍. 然而,在没有这些特定适应症的情况下的常规导管治疗在本研究中对临床决策的影响有限.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 成年人的先天性心脏病
背景情况:
- 常规诊断心脏导管在无症状的Fontan患者的临床效用是有争议的.
- 关于它在这个人群中的有效性没有确立的共识.
研究的目的:
- 评估诊断性心脏导管是否会改变Fontan循环患者的临床管理.
- 评估对各种适应症的导管治疗的影响.
主要方法:
- 对2016-2019年接受诊断性心脏导管治疗的成年Fontan患者 (≥16岁) 的回顾性分析.
- 排除接受电生理学研究的患者.
- 常规导管术的定义是发生在Fontan后5年以上,没有先前的诊断导管术.
主要成果:
- 分析了38名患者 (平均年龄27±7岁) 的41项手术.
- 在59%的病例中,导管治疗导致了管理变化,包括干预,手术,药物调整和移植转诊.
- 诸如蓝色症,呼吸不全和已识别的血液动力学病变等迹象推动了管理变化.
- 常规导管和肝硬度评估对管理没有影响.
结论:
- 诊断性心脏导管治疗对于患有症状 (呼吸不全,阴症) 或怀疑血液动力学损伤的Fontan患者来说是有价值的.
- 无症状Fontan患者的常规心脏导管治疗对临床管理的影响有限.
相关概念视频
01:30Pulse rhythm
755
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
755
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
82
Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
82
01:20Imaging Studies for Cardiovascular System III: X-Ray
141
The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
141
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
98
Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
98