在全腔肺连接后的患者中,对Fontan通路阻塞的干预措施
Nicole Piber1, Christina Ruda2,3,4, Thibault Schaeffer2,3,4
1Department of Cardiovascular Surgery, TUM University Hospital German Heart Center, 80636 Munich, Germany.
Journal of clinical medicine
|October 29, 2025
概括
接受全腔肺连接 (TCPC) 的21%患者需要因Fontan通路阻塞而进行干预,主要是用支架治疗的左肺动脉狭窄症. 风险因素包括之前的诺伍德手术和TCPC之前的高肺动脉压.
科学领域:
- 心血管外科心血管外科
- 儿童心脏病学 儿童心脏病学
- 干预心脏病学 干预心脏病学
背景情况:
- 丰坦通路的阻塞是全腔肺连接 (TCPC) 后的一个显著并发症.
- 了解TCPC通路阻塞的发生率,位置和治疗对于改善患者的治疗结果至关重要.
研究的目的:
- 评估全腔肺连接通道阻塞的发生率和解剖位置.
- 确定与TCPC途径干预相关的风险因素.
- 分析这些干预措施对长期结果的影响.
主要方法:
- 在1994年至2023年期间接受TCPC治疗的患者的回顾性分析.
- 对TCPC通路阻塞的术后干预措施的评估,包括导管和外科手术.
- 确定需要干预的患者的风险因素和结果评估.
主要成果:
- 在650名患者中,有136名患者 (21%) 需要为TCPC通路阻塞进行干预,主要是左肺动脉狭窄 (107例),主要用支架进行治疗.
- 1,3,5年和10年没有干预的情况分别为87.7%,85.3%,83.6%和78.5%.
- 确定的危险因素包括先前的诺伍德手术,管道支架,先前的肺动脉干预和TCPC前的高肺动脉压力. 需要干预的患者患蛋白质丧失肠病,塑性支气管炎和Fontan衰竭的比率更高.
结论:
- 在21%的TCPC患者中,对Fontan通路阻塞的干预是必要的,左肺动脉狭窄是最常见的病变.
- 早期识别风险因素,如之前的诺伍德手术和高肺动脉压力,对于风险分层至关重要.
- 对通路阻塞的干预与增加的发病率有关,包括蛋白质丧失肠病和塑性支气管炎.
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