复杂先天性心脏病的镶嵌治疗

Hybrid procedures for complex congenital heart disease

近年随着小儿心导管技术的迅速发展,先天性心脏病已从以往的单纯手术治疗转变为手术和介入共同治疗。对于一些复杂的先天性心脏病,内科介入技术与外科手术相互结合的镶嵌治疗模式已经成为一个主要的发展方向,在围手术期应用介入技术支持外科手术可以达到更好的治疗效果。通过镶嵌治疗不仅可以提高治疗的效果,降低手术和介入治疗各自的风险,同时有利于手术方法的改良,也减轻了患者的痛苦和家庭的经济负担。

As collaboration between surgeon and interventionalist has improved, hybrid procedures for congenital heart disease （CHD） is progressing remarkably and becoming a developing therapeutics for complex CHD. The goals of hybrid therapy are （1） to reduce morbidity and mortality, （2） to reduce the cumulative impact of interventions, （3） to improve quality of life, and （4） to deliver more efficient and cost effective care. Some studies have demonstrated the feasibility of a hybrid approach to complex congenital cardiac surgery. Pre-, intra- or postoperative intervention by cardiologist can be performed safely and may be complementary in patients with complex CHD by providing a better result in combination with cardiac surgery than either alone can offer.