先天性主动脉缩窄的介入治疗

Interventional treatment for congenital coarctation of aorta

目的 评价经皮血管成形术 (PTA)与血管内支架 (ES)置入治疗先天性主动脉缩窄的近中期疗效。方法 9例先天性主动脉缩窄患者 (6例合并其他心血管疾患 )接受治疗 ,其中 6例单独行PTA治疗 ,3例行PTA与ES。术后行 1～ 78个月的随访。结果 9例先天性主动脉缩窄介入治疗成功率为 10 0 %。术后即刻疗效好 ,跨缩窄处收缩压差由术前 (6 4 4 4± 9 2 7)mmHg(1mmHg =0 133kPa)降至 (16 89± 7 5 2 )mmHg(P <0 0 1) ,术前与术后主动脉缩窄段最窄处直径由 (3 5 9± 1 0 0 )mm增至(12 0 8± 2 5 5 )mm(P <0 0 1)。目前平均随访 (32 11± 2 5 6 6 )个月 (1～ 78个月 ) ,8例疗效满意 ,1例患者PTA术后 3年出现症状性高血压 ,外院接受ES置入 ,术后 3个月因症状反复行外科手术治疗。结论 介入方法治疗先天性主动脉缩窄安全、有效。

Objective To evaluate the short and long-term efficacy of percutaneous transluminal angioplasty (PTA) and implantation of stent in the treatment of congenital coarctation of aorta.Methods Nine cases suffered from congenital coarctation of aorta including 6 cases afflicted with other cardiac anomalies underwent interventional therapy.Six cases underwent PTA.Three cases underwent PTA and implantation of stent.All the cases were examined with follow-up data from 1 to 78 months.Results The universal successful rate of the 9 cases with coarctation of aorta was 100%.The results of follow-up data indicated the therapy efficacy of 8 cases was stable and there was no relapse,but 1 case appeared symptomatic hypertension 3 years after PTA and relapsed 3 months after implantation of stent.Conclusion Interventional therapy including PTA and implantation of stent for coarctation of aorta is safe and effective.