赵昌学,宋艳苹,冯冗

• 1:菏泽市立医院心脏血管外科
• 2:菏泽医学专科学校

摘要(Abstract)：

目的评价NuMED CP覆膜支架治疗成人主动脉缩窄的临床效果。方法对6例主动脉缩窄患者行NuMED CP覆膜支架置入术,男4例,女2例,平均年龄(20.13±5.16)岁。根据术前行主动脉CT血管造影(CT angiography,CTA)检查选择合适型号的支架和球囊;经股动脉穿刺送入装载有支架的球囊导管,准确定位后充盈内、外球囊,扩张覆膜支架。术毕应用血管缝合器缝合血管穿刺点。结果 6例患者均成功置入NuMED CP覆膜支架。导管测得跨缩窄段压差由术前(59.32±15.78)mm Hg(1 mm Hg=0.133 k Pa)下降至(10.83±3.66)mm Hg(P<0.001),主动脉缩窄最窄处直径由术前(5.1±1.2)mm增加至(19.7±2.4)mm(P<0.001)。2例合并动脉导管未闭患者,分流完全消失,上下肢血压恢复正常。患者术后随访12~36个月,活动后心慌、四肢乏力症状明显缓解。6例患者血压均正常,停服降压药物,无剧烈活动后胸闷和头痛、头晕等症状。术后3个月行多普勒超声或胸主动脉CTA检查,主动脉缩窄段直径明显改善,无死亡病例。结论 NuMED CP覆膜支架对治疗成人主动脉缩窄的近期疗效满意,远期疗效有待进一步观察。

关键词(KeyWords)： 主动脉缩窄;NuMED CP覆膜支架;介入治疗

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 赵昌学,宋艳苹,冯冗

参考文献(References)：

• [1]Feltes TF,Bacha E,Beekman RH 3rd,et al.Indications for cardiac catheterization and intervention in pediatric cardiac disease:a scientific statement from the American Heart Association.Circulation,2011,123(22):2607-2652.
• [2]吴成权,何晓虹,张幼祥,等.彩色多普勒超声心动图对先天性主动脉缩窄的诊断价值.中国临床医学影像学杂志,2009,20(4):281-283.
• [3]Abbruzzese PA,Aidala E.Aortic coarctation:an overview.J Cardiovasc Med(Hagerstown),2007,8(2):123-128.
• [4]Levelt E,Bellenger NG.Complication of aortic coarctation repair surgery.Heart,2009,95(13):1090.
• [5]Singer MI,Rowen M,Dorsey TJ.Transluminal aortic balloon angioplasty for coarctation of the aorta in the newborn.Am Heart J,1982,103(1):131-132.
• [6]Rao PS,Galal O,Smith PA,et al.Five-to nine-year follow-up results of balloon angioplasty of native aortic coarctation in infants and children.J Am Coll Cardiol,1996,27(2):462-470.
• [7]张克伟,翟水亭,史帅涛,等.腔内介入治疗成人型主动脉缩窄的临床经验及中期随访结果.中华放射学杂志,2013,47(10):942-944.
• [8]周万平,李奋,高伟,Cheatham-Platinum支架置入治疗儿童主动脉缩窄的疗效评价.心肺血管病杂志,2014,33(4):478-482.
• [9]Warnes CA,Williams RG,Bashore TM,et al.ACC/AHA 2008guidelines for the management of adults with congenital heart disease:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines(Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease).Developed in Collaboration With the American Society of Echocardiography,Heart Rhythm Society,International Society for Adult Congenital Heart Disease,Society for Cardiovascular Angiography and Interventions,and Society of Thoracic Surgeons.J Am Coll Cardiol,2008,52(23):e143-263.
• [10]韩晓峰,黄小勇,郭曦,等.覆膜CP支架治疗主动脉缩窄的临床应用研究.心肺血管病杂志,2013,32(4):414-417.
• [11]张端珍,朱鲜阳,崔春生,等.介入治疗主动脉缩窄14例临床分析.中国介入心脏病学杂志,2010,18(6):321-324.