摘要
目的评价儿童不同类型冠状动脉瘘（CAF）介入封堵治疗的近中期疗效、并发症及抗凝治疗方案。方法回顾性分析2006年1月至2014年1月行CAF介入封堵治疗的12例患儿术前、造影及术后随访资料,记录不同类型CAF的封堵方式、抗凝方案、术后并发症、辅助检查结果。结果本组患儿年龄1~158个月;近端型/中型4例,近端型/大型5例,远端型/中型3例,均成功封堵;术后随访3.5±2.4年;11例患儿术后口服阿司匹林6个月,1例口服18个月;无血栓、介入并发症,术后左心室射血分数、心胸比、肺动脉压下降,病变冠状动脉开口直径减小。结论儿童期介入封堵治疗近端型和远端型/中型CAF近中期疗效、安全性满意;术后阿司匹林抗凝治疗可预防近中期血栓事件,但疗程和安全性有待进一步随访研究。
Objective To evaluate the short- and medium-term efficacy, complications, and anti-coagulation therapies related to transcatheter closure（TCC） of coronary artery fistula（CAF） in children. Methods We conducted a retrospective review of the medical records of 12 children with CAF who underwent TCC between January 2006 and January 2014, focusing on details such as preoperative, radiographic, and postoperative follow-up data, to record closure methods for CAF, anti-coagulation therapies, postoperative complications, and results of auxiliary examinations. Results Among the 12 cases who underwent successful TCC and whose age was 1-158 months, four patients had proximal/medium-sized CAF, five had proximal/large CAF, and three had distal/medium-sized CAF. The mean period of postoperative follow-up was 3.5±2.4 years. Eleven patients took aspirin for 6 months post closure, and one took it for 18 months. Neither coronary thrombosis nor interventional complications were found. Left ventricular ejection fraction, cardiothoracic ratio, pulmonary artery pressure, and the diameters of coronary artery lesions decreased post TCC. Conclusions TCC is feasible and safe in proximal and distal/medium-sized CAF patients. Postoperative anticoagulation with aspirin may prevent short- and medium-term thrombosis, but treatment course and safety need to be investigated by further follow-ups.
出处
《中国当代儿科杂志》
CAS
CSCD
北大核心
2015年第4期384-389,共6页
Chinese Journal of Contemporary Pediatrics
关键词
冠状动脉瘘
介入封堵术
随访
儿童
Coronary artery fistula
Transcatheter closure
Follow-up
Child
