普通弹簧圈联合Interlock可解脱弹簧圈栓塞体肺侧支在复杂先天性心脏病治疗中的临床应用

Combined use of coil and Interlock detachable coil for embolization of collateral vessels in surgical treatment of congenital heart disease

目的探讨COOK普通弹簧圈联合可解脱带纤维毛弹簧圈栓塞系统栓塞体肺侧支在复杂先天性心脏病(先心病)外科治疗中的应用价值及经验。方法回顾性分析2016年1月至2018年8月中国医学科学院阜外医院收治的15例复杂先心病合并体肺侧支患者的临床资料,评价COOK普通弹簧圈联合可解脱带纤维毛弹簧圈栓塞系统在体肺侧支栓塞术中的可行性、安全性和有效性。结果15例患者中共发现33支体肺侧支血管,均栓塞成功,无血管损伤、弹簧圈移位及脱落等术中并发症发生。术中共用COOK普通弹簧圈34枚,直径3~8 mm,长度3~8 cm;共用Interlock可解脱弹簧圈28枚,其中15枚为钻石型,13枚为普通2D型,弹簧圈直径为2~6 mm,长度为2.3~8.0 cm。15例患者中10例属于杂交手术,即在杂交手术室行体肺侧支栓塞术后即刻行外科手术;5例因先心病外科术后发生灌注肺或左心功能不全需持续呼吸机辅助通气,不能拔除气管插管而行心血管造影及体肺侧支栓塞术,术后均顺利拔除气管插管。结论COOK普通弹簧圈联合可解脱带纤维毛弹簧圈栓塞系统栓塞体肺侧支在复杂先心病治疗中疗效确切,可推广应用。

Objective To evaluate the effi ciency of combined use of COOK coils and interlocking detachable coils for embolization of aortopulmonary collateral vessels in surgical treatment of patients with cyanotic congenital heart disease.Methods From January 2016 to August 2018,combined use of COOK coils and interlocking detachable coils for embolization of collateral vessels were successfully performed in 15 patients with cyanotic congenital heart disease.Results 33 collateral vessels were found among the 15 patients and all vessels were successfully embolized,there was no damage of vessel or drop of coils occurred.A total of 34 COOK coils were used,the diameter varied from 3-8mm and length from 3-8cm;a total of 28 Interlock detachable coils were used,including 15 of diamond type and 13 of normal 2D type,the diameter varied from 2–6 mm and length from 2.3–8.0 cm.There were 10 hybrid approaches among 15 patients,and collateral vessel embolization was performed in 5 patients due to left heart failure after surgery,and the 5 patients recovered and were discharged uneventfully.Conclusions COOK coils combined with interlocking detachable coils for embolization of aortopulmonary collateral vessels is an eff ective and safe method in surgical treatment of patients with cyanotic congenital heart disease.