Dilatation and stenting of the fontan pathway: impact of the stenosis treatment on chronic ascites.
作者： STANISLAV OVROUTSKI , PETER EWERT , VLADIMIR ALEXI-MESKISHVILI , BJORN PETERS , ROLAND HETZER
DOI: 10.1111/J.1540-8183.2007.00323.X
关键词: Ascites 、 Medicine 、 Surgery 、 Internal medicine 、 Cardiology 、 Fontan pathway 、 Stenosis 、 Heart catheterization 、 Hemodynamics 、 Pulmonary artery 、 In patient 、 Complete resolution
摘要: Objective: Low pulmonary artery pressure (PAP) and unobstructed flow in the arteries (PA) systemic veins are most important factors for optimal long-term Fontan hemodynamics. We retrospectively analyzed impact of transcatheter interventions treatment stenoses pathway to optimize circulation, with special attention chronic ascites. Patients Design: Sixty-three a total 112 patients underwent heart catheterization 4.6 (1.0–11.4) years after operation. The median age at end follow-up was 11 (3.1–45) years. Patients were divided into two groups, one ascites without. elevated PAP morphologic development analyzed. Results: Ascites observed patients; 5 them had stenosis (P = 0.010). High 15 mmHg or more (n 13) correlated positively (5 13, P 0.040). Twenty removal performed 14 patients. temporary relief all complete resolution alleviation 2 <12 mmHg. Conclusion: Transcatheter can effectively improve hemodynamics even without measurable gradient. In those low PAP, it may lead disappearance ascites.
sci-hub.se 参考文章(21)
Seisuke Nakata, Yasuharu Imai, Yoshinori Takanashi, Hiromi Kurosawa, Kitsuhiro Tezuka, Makoto Nakazawa, Masahiko Ando, Atsuyoshi Takao, A new method for the quantitative standardization of cross-sectional areas of the pulmonary arteries in congenital heart diseases with decreased pulmonary blood flow. The Journal of Thoracic and Cardiovascular Surgery. ,vol. 88, pp. 610- 619 ,(1984) , 10.1016/S0022-5223(19)38300-X
John J. Lamberti, Richard D. Mainwaring, Robert L. Spicer, Karen C. Uzark, John W. Moore, Factors influencing perioperative morbidity during palliation of the univentricular heart The Annals of Thoracic Surgery. ,vol. 60, pp. 550- 553 ,(1995) , 10.1016/0003-4975(95)00769-5
Marshall L. Jacobs, Jack Rychik, Craig J. Byrum, William I. Norwood, Protein-losing enteropathy after fontan operation: Resolution after baffle fenestration The Annals of Thoracic Surgery. ,vol. 61, pp. 206- 208 ,(1996) , 10.1016/0003-4975(95)00659-1
Tain-Yen Hsia, Sachin Khambadkone, John E Deanfield, James FN Taylor, Francesco Migliavacca, Marc R de Leval, None, Subdiaphragmatic venous hemodynamics in the Fontan circulation The Journal of Thoracic and Cardiovascular Surgery. ,vol. 121, pp. 436- 447 ,(2001) , 10.1067/MTC.2001.112527
Albert C. Lardo, Steven A. Webber, Ingeborg Friehs, Pedro J. del Nido, Edward G. Cape, Fluid dynamic comparison of intra-atrial and extracardiac total cavopulmonary connections The Journal of Thoracic and Cardiovascular Surgery. ,vol. 117, pp. 697- 704 ,(1999) , 10.1016/S0022-5223(99)70289-8
D.J. Penny, Z. Hayek, A.N. Redington, The effects of positive and negative extrathoracic pressure ventilation on pulmonary blood flow after the total cavopulmonary shunt procedure International Journal of Cardiology. ,vol. 30, pp. 128- 130 ,(1991) , 10.1016/0167-5273(91)90137-E
P. R. Vouhé, Fontan completion: intracardiac tunnel or extracardiac conduit? Thoracic and Cardiovascular Surgeon. ,vol. 49, pp. 27- 29 ,(2001) , 10.1055/S-2001-9912
Igor E. Konstantinov, Francisco J. Puga, Vladimir V. Alexi-Meskishvili, Thrombosis of intracardiac or extracardiac conduits after modified Fontan operation in patients with azygous continuation of the inferior vena cava. The Annals of Thoracic Surgery. ,vol. 72, pp. 1641- 1644 ,(2001) , 10.1016/S0003-4975(01)03146-0
V. Alexi-Meskishvili, S. Ovroutski, P. Ewert, J.-H. Nürnberg, B. Stiller, H. Abdul-Khaliq, R. Hetzer, P. E. Lange, Mid-term follow-up after extracardiac Fontan operation. Thoracic and Cardiovascular Surgeon. ,vol. 52, pp. 218- 224 ,(2004) , 10.1055/S-2004-821016
Christopher J. Knott-Craig, Paul R. Julsrud, Hartzell V. Schaff, Francisco J. Puga, Gordon K. Danielson, Pulmonary artery size and clinical outcome after the modified Fontan operation The Annals of Thoracic Surgery. ,vol. 55, pp. 646- 651 ,(1993) , 10.1016/0003-4975(93)90268-M