在婴儿中以胸前回声心脏成像为指导的下大风中心室隔膜缺陷的关闭:一个病例报告
Radityo Prakoso1, Rina Ariani2, Yovi Kurniawati1
1Division of Pediatric Cardiology and Congenital Heart Disease, Department of Cardiology and Vascular Medicine, National Cardiovascular Centre of Harapan Kita, Universitas Indonesia, Jakarta, Indonesia.
Frontiers in cardiovascular medicine
|October 10, 2025
概括
在10公斤以下的婴儿中,穿皮关闭下心室隔膜缺陷 (VSD) 是安全有效的. 这种零光镜方法使用跨胸腔心声学指导,最大限度地减少了儿科VSD治疗的并发症.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 干预心脏病学 干预心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 与周膜缺陷相比,室隔膜缺陷 (VSD) 携带更高的并发症风险,如大动脉缺陷和AV阻塞.
- 在10公斤以下的婴儿中,手术关闭VSD可能具有挑战性,需要采用最小侵入性的替代方案.
研究的目的:
- 评估体重小于10公斤的婴儿皮肤下静脉关闭的安全性和有效性.
- 评估使用跨胸腔心声学 (TTE) 专为在手术期间的指导而使用的可行性,避免光学.
主要方法:
- 在一个8.9公斤体重的婴儿中,用于穿皮关闭,采用逆向的跨动脉方法,该婴儿患有亚动脉VSD.
- 在TTE指导下部署了7/5mm的Konar-MF VSD Occluder,利用各种回声心脏图像来准确定位导管和设备.
- 该程序没有进行光学,仅依靠TTE进行实时可视化.
主要成果:
- 在婴儿中,成功地通过皮肤关闭了下静脉VSD.
- 设备部署后立即没有检测到任何剩余的分流.
- 婴儿表现出症状缓解,设备在六个月的随访中仍然很好地坐着,没有严重的并发症.
结论:
- 仅由TTE指导的零光镜皮下静脉关闭是10kg以下的选定的婴儿的可行和安全的选择.
- 这种技术为手术提供了一个有希望的替代方案,可以减少儿科患者的辐射暴露.
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