主动脉缩窄的治疗

Coarctation of the aorta:therapeutic progresses

通过总结分析主动脉缩窄(CoA)的治疗情况,对其治疗方式及治疗时机的选择做出提示。将CoA分为7种类型进行分析,治疗方式从外科手术、介入治疗及镶嵌治疗3个方面进行比较。外科手术治疗作为传统的治疗方式,在复杂CoA治疗中仍占有重要地位;随着介入治疗的开展,经皮球囊扩张血管成形术(PTA)与血管内支架(ES)置入术在某些CoA治疗中已取得良好效果;为使相应CoA得到更好治疗,镶嵌治疗已渐成为趋势;手术时机因类型而异,对严重的CoA目前倾向于婴儿期治疗。CoA的治疗应权衡选择最合适的治疗方式及时机,以达到最佳治疗效果。

This paper reviews the current progress in treatment of coarctation of the aorta （CoA） to reveal a better choice of treatment and opportunity. CoA was classified into 7 styles and comparison of different therapies such as surgery, interventional therapy and hybrid procedure was performed. Surgery, as a traditional way of treating complex CoA is still an important option. With the development of interventional therapy, pereutaneous balloon angioplasty and endovascular stent implantation were reported effective in some CoA cases, while hybrid procedure gradually becomes the tendency. The time window for surgery depends on the classification of this disease. It is suggested from literature that severe CoA should be treated in infancy. Optimal outcome can be achieved by choosing proper regimes of treatment and time window for CoA.