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Assessment of Intracardiac and Extracardiac Deformities in Patients with Various Types of Pulmonary Atresia by Dual-Source Computed Tomography
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作者 Wenlei Qian Xinzhu Zhou +4 位作者 Ke Shi Li Jiang Xi Liu Liting Shen Zhigang Yang 《Congenital Heart Disease》 SCIE 2023年第1期113-125,共13页
Background:Pulmonary atresia(PA)is a group of heterogeneous complex congenital heart disease.Only one study modality might not get a correct diagnosis.This study aims to investigate the diagnostic power of dualsource ... Background:Pulmonary atresia(PA)is a group of heterogeneous complex congenital heart disease.Only one study modality might not get a correct diagnosis.This study aims to investigate the diagnostic power of dualsource computed tomography(DSCT)for all intracardiac and extracardiac deformities in patients with PA compared with transthoracic echocardiography(TTE).Materials and Methods:This retrospective study enrolled 79 patients and divided them into three groups according to their main diagnosis.All associated malformations and clinical information,including treatments,were recorded and compared among the three groups.The diagnostic power of DSCT and TTE on all associated malformations were compared.The surgical index(McGoon ratio,pulmonary arterials index(PAI),and total neopulmonary arterial index)and radiation dose were calculated on the basis of DSCT.Results:Of the patients,32,30,and 17 were divided into the groups of PA with ventricular septal defect(VSD),PA with VSD and major aortopulmonary collateral arteries,and PA with other major malformations,respectively.Consequently,182,162,and 13 intracardiac,extracardiac,and other major malformations were diagnosed,respectively.Moreover,DSCT showed a better diagnostic performance in extracardiac deformities(154 vs.117,p<0.001),whereas TTE could diagnose intracardiac deformities better(159 vs.139,p=0.001).The McGoon ratio,PAI,and treatment methods were significantly different among the three groups(p=0.014,p=0.008,and p=0.018,respectively).Conclusion:More than one imaging modality should be used to make a correct diagnosis when clinically suspecting PA.DSCT is superior to TTE in diagnosing extracardiac deformities and could be used to roughly calculate surgical indices to optimize treatment strategy. 展开更多
关键词 pulmonary atresia complex congenital heart diseases dual-source computed tomography transthoracic echocardiography
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Role of Surgery on Growth of Tricuspid Valve in Pulmonary Atresia with Intact Ventricular Septum:Mid-Term Results of Modified Right-Ventricular Overhauling Procedure
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作者 Jae Gun Kwak Eung Re Kim +3 位作者 Taeyoung Yun Sungkyu Cho Chang-Ha Lee Woong-Han Kim 《Congenital Heart Disease》 SCIE 2023年第3期325-336,共12页
Objectives:To access the effectiveness of our modified right-ventricular overhauling procedure on tricuspid valve(TV)growth in patients with pulmonary atresia with intact ventricular septum(PAIVS).Methods:We retrospec... Objectives:To access the effectiveness of our modified right-ventricular overhauling procedure on tricuspid valve(TV)growth in patients with pulmonary atresia with intact ventricular septum(PAIVS).Methods:We retrospectively reviewed 21 patients with PAIVS who underwent modified right ventricular overhauling(mRVoh)between 2008 and 2019 at two institutions.Our mRVoh consisted of wide resection of hypertrophied infundibular and trabecular muscle,peeling off fibrotic endocardial tissue in the right ventricle(RV)cavity,surgical pulmonary valvotomy,and Blalock-Taussig shunt or banding of ductus arteriosus under cardiopulmonary bypass.The TV annulus sizes were measured and analyzed using echocardiography before and after mRVoh.Results:No mortalities were observed during a median follow-up of 3 years(interquartile range:1.3–4.7 years)of follow-up were noted.mRVoh was performed at a median age of 163.5 days(range:21–560 days),including seven neonates and two infants(<60 days).During follow-up,the median TV annular z-score increased significantly from−2.24 to−1.15 before and after mRVoh(p=0.004).In ten patients with a prior history of percutaneous interventions for RV outflow tract(RVOT)widening at least 6 months before mRVoh,the TV annular z-score significantly changed during the period after mRVoh(−2.03 to−1.61,p=0.028)compared with the period before mRVoh(−2.51→–2.03,p=0.575)after percutaneous intervention only.Conclusions:mRVoh in PAIVS patients was positively associated with TV annular growth,and it was more effective than percutaneous RVOT widening interventions without mRVoh. 展开更多
关键词 Congenital heart disease cyanotic heart disease pulmonary atresia with intact ventricular septum right ventricular overhauling
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Anatomy in Patients with 22q11 Deletion and Pulmonary Atresia with Ventricular Septal Defect and Major Aortopulmonary Collaterals 被引量:1
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作者 Ashish O. Sureka Lynn F. Peng +2 位作者 Olaf Reinhartz V. Mohan Reddy Frank L. Hanley 《Surgical Science》 2011年第5期294-296,共3页
We performed a retrospective analysis of patients with and without 22q11 deletion undergoing surgery for pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals between January 2004 and A... We performed a retrospective analysis of patients with and without 22q11 deletion undergoing surgery for pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals between January 2004 and August 2009 at our institutions. Information was collected on collateral origin, arch sidedness, presence of central pulmonary arteries, and presence of an aberrant subclavian vessel. While patients with 22q11 deletion were more likely to have collateral origin from brachiocephalic vessels, patients without 22q11 deletion were more likely to have collateral origin from the descending aorta. There was no significant difference in arch sidedness or the presence of central pulmonary arteries. Patients with 22q11 deletion were more likely to have an aberrant subclavian artery (15/46 vs 5/54, p < 0.05), whether a left or right arch was present. Nine of the fifteen 22q11 deletion patients had a collateral originating from an aberrant subclavian artery. In time, genomic and embryologic research may help determine the exact mechanisms by which 22q11 deletion contributes to the development of congenital heart disease such as pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals. 展开更多
关键词 Tetralogy of Fallot with pulmonary atresia pulmonary atresia with VENTRICULAR SEPTAL Defect 22q11 DELETION
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Right Sub-Axillary Incision for Right Pulmonary Vein Atresia in a Child:A Case Report and Literature Review
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作者 Weitao Zhang Xinhua Wei +2 位作者 Jintao Zhang Fengfeng Wang Qun Li 《Journal of Clinical and Nursing Research》 2023年第3期33-38,共6页
Unilateral pulmonary vein atresia(UPVA)in children is a rare disease that is characterized by a recurrent pulmonary infection and hemoptysis in childhood.This paper is a report of a case of pulmonary venous atresia tr... Unilateral pulmonary vein atresia(UPVA)in children is a rare disease that is characterized by a recurrent pulmonary infection and hemoptysis in childhood.This paper is a report of a case of pulmonary venous atresia treated by a right sub-axillary incision.Hopefully,more literature can be produced to improve the awareness and treatment level of pulmonary vein atresia. 展开更多
关键词 Right sub-axillary incision Unilateral pulmonary vein atresia Children pulmonary collateral vessels
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A Novel Perspective on Histopathology Provides Novel Insights into Surgical Effects in Pulmonary Atresia,Ventricular Septal Defect,and Major Aortopulmonary Collateral Arteries:A Case-Series Study
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作者 Jinyang Liu Xianchao Jiang +5 位作者 Runsi Wang Li Li Ju Zhao Fuxia Yan Run Yuan Qiang Wang 《Congenital Heart Disease》 SCIE 2021年第3期245-254,共10页
Background:Never had literatures characterized the relationship between the property of major aortopulmonary collateral arteries(MAPCAs)and outcomes of selective unifocalization of pulmonary atresia with ventricular s... Background:Never had literatures characterized the relationship between the property of major aortopulmonary collateral arteries(MAPCAs)and outcomes of selective unifocalization of pulmonary atresia with ventricular septal defects and MAPCAs.Methods:This is a case-series study.Thirteen patients were included.Angiographybased assessment was conducted to determine whether collateral arteries should be unifocalized or treated with intraoperative ligature.Specimens were collected and stained by HE and ET+VG.Results:Twelve patients underwent one-stage unifocalization at a median age of 37 months(range:6–228 months)and a median weight of 14.0 kg(range:5.0–49.0 kg),which produced a favorable right ventricle to aortic systolic pressure ratio of no more than 0.5 except in one patient who died.Patients were divided into three groups:Group 1(n=6),had no native pulmonary arteries,and collateral arteries supplied all pulmonary blood;Group 2(n=6)presented dysplastic native pulmonary arteries on one or both sides,and in some lung lobes or segments,blood was supplied only by collateral arteries;Group 3(n=1)had well-developed left and right pulmonary arteries,and collateral arteries,and pulmonary arteries provided blood flow to the same segments.Pathological reports demonstrated two types of collateral arteries:Elastic arteries presented an arborization distribution similar to native pulmonary artery walls,while muscular arteries showed high resistance and distortion.We selectively unifocalized single-supply collateral arteries with morphologic features based on the arborization distribution.Conclusions:We found that there were two kinds of MAPCAs with different histology,and we performed selective UF for MAPCAs that might belong to the elastic artery.Selective unifocalization achieved a low right ventricle to aortic systolic pressure ratio and favorable surgical effects. 展开更多
关键词 HISTOpaTHOLOGY selective unifocalization pulmonary atresia major aortopulmonary collateral arteries
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Whole Exome Sequencing Identifies A Novel Pathogenic Bmpr2 Variant in Pulmonary Atresia
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作者 Muyu Qi Xiaoping Lan +3 位作者 Jia Li Junwen Ge Li Shen Rufang Zhang 《Congenital Heart Disease》 SCIE 2021年第5期487-498,共12页
Objective:Pulmonary atresia(PA)is a rare type of complex cyanotic congenital heart defect characterized primarily by an undeveloped pulmonary valve or pulmonary artery.Therefore,defining a disease-causing gene mutatio... Objective:Pulmonary atresia(PA)is a rare type of complex cyanotic congenital heart defect characterized primarily by an undeveloped pulmonary valve or pulmonary artery.Therefore,defining a disease-causing gene mutation in a pulmonary atresia family is a possible method of genetic counseling,future prenatal diagnosis,and therapeutic approaches for pulmonary atresia.Methods:Blood samples were collected from six PA family members,and genomic DNA was extracted using the QIAamp DNA Blood Mini Kit.Gene detection was performed using a second-generation sequencing gene panel.Results:Genetic testing results indicated that a heterozygous mutation originating from maternal inheritance was detected in the BMPR2 gene of the proband’s genomic DNA.The pathogenic gene was c.2804C>T(p.A935V).The mutation was also detected in the genomic DNA of the proband’s elder brother(III-1),but not in other family members.Conclusion:To the best of our knowledge,this is the first study to report the BMPR2 variant responsible for pulmonary atresia.The frequency of the c.2804C>T(p.A935V)mutation detected in this family is extremely low in the normal population(1/246048).The mutation was highly conserved among different species.Sorting intolerant from tolerant(SIFT)predicts it to be a harmful mutation. 展开更多
关键词 pulmonary atresia gene mutation BMPR2 gene
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Management of ductal spasm in a neonate with pulmonary atresia and an intact ventricular septum during cardiac catheterization:A case report
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作者 Xu Zhang Ning Zhang +1 位作者 Hai-Cheng Song Yue-Yi Ren 《World Journal of Clinical Cases》 SCIE 2022年第35期13015-13021,共7页
BACKGROUND Ductal spasm is a rare but life-threatening complication of cardiac catheterization in neonates with pulmonary atresia and an intact ventricular septum.In patients with ductal-dependent pulmonary blood flow... BACKGROUND Ductal spasm is a rare but life-threatening complication of cardiac catheterization in neonates with pulmonary atresia and an intact ventricular septum.In patients with ductal-dependent pulmonary blood flow,ductal spasm may lead to refractory hypoxemia and severe hemodynamic instability,which need to be treated in perfect order.CASE SUMMARY We present a male infant with a gestational age of 39 wk,and his fetal echocardiography showed pulmonary atresia.At 28 d of age,transcatheter pulmonary valvuloplasty with balloon dilatation was performed.Two hours after the operation,the patient's pulse oxygen saturation continued to decrease.The patient was then transferred to receive cardiac catheterization.During catheterization,the invasive blood pressure and pulse oxygen saturation suddenly decreased,and repeated aortography revealed partial occlusion of the ductus arteriosus.It no longer changed when pulse oxygen saturation rose to 51%after approximately 20 min of maintenance therapy.Therefore,a ductal stent was used for implantation.Hemodynamics and hypoxemia were improved.CONCLUSION We should know that ductal spasm may occur during pulmonary atresia and intact ventricular septum cardiac catheterization.Understand the pathophysiology of ductal-dependent pulmonary blood flow and make comprehensive perioperative preparations essential to deal with hemodynamic disorders caused by ductal spasm. 展开更多
关键词 Cardiac catheterization Ductus arteriosus Ductal stent Ductal spasm Intact ventricular septum pulmonary atresia Case report
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Arrhythmic Risk in Paediatric Patients Undergoing Surgical Repair for Pulmonary Atresia with Intact Ventricular Septum
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作者 Pietro Paolo Tamborrino Corrado Di Mambro +7 位作者 Cecilia Marcolin Walter Vignaroli Giulia Cafiero Gianluca Brancaccio Sonia Albanese Massimo Stefano Silvetti Adriano Carotti Fabrizio Drago 《Congenital Heart Disease》 SCIE 2021年第1期85-94,共10页
Introduction:While previous studies only focused on the arrhythmic risk associated with specific correction strategies,this study evaluates this risk in a large cohort of paediatric patients with all phenotypes of PA-... Introduction:While previous studies only focused on the arrhythmic risk associated with specific correction strategies,this study evaluates this risk in a large cohort of paediatric patients with all phenotypes of PA-IVS after surgical repair.Methods:In this single centre observational cohort study,we retrospectively evaluated 165 patients with a diagnosis of PA-IVS and we excluded those with an exclusively percutaneous treatment,patients lost or with insufficient follow-up and those affected by other arrhythmic syndromes.Surgical history and clinical outcomes were reviewed.Results:86 patients were included in the study(54 male[62.8%],mean age 16.4±6.1 years),with median follow-up from definitive repair of 12.8 years(6.4–18.9 years).They underwent three different final repairs:23 patients(26.7%)univentricular palliation,43(50%)biventricular correction,and 20(23.3%)one and a half ventricle correction.Thirteen patients(15%)developed arrhythmia:6 patients(all the subgroups)sinus node disfunction(SND);2(biventricular repair)premature ventricular complexes;2(one and a half ventricle repair)non-sustained ventricular tachycardia;1(biventricular repair)intra-atrial re-entrant tachycardia;1(one and a half ventricle repair)supraventricular tachyarrhythmia;1(biventricular repair)atrial fibrillation.Three patients with SND needed a pacemaker implantation.Only Fontan circulation showed an association with SND,while the other two groups heterogeneous types of arrhythmias.Conclusions:The low arrhythmic risk is related to surgical repair,it does not appear to be associated with native cardiomyopathy,and it appears to increase with length of follow up.Continuous follow-up in specialized centres is necessary to make an early diagnosis and to manage the potential haemodynamic impact at medium-long term. 展开更多
关键词 pulmonary atresia with intact ventricular septum arrhythmic risk univentricular palliation Fontan circulation biventricular repair one and a half repair
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Valvuloplasty of fetal pulmonary atresia with intact ventricular septum and hypoplastic right heart: Mid-term follow-up results 被引量:2
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作者 Gang Luo Shuai Gao +4 位作者 Hongxiao Sun Zhixian Ji Dunliang Wang Yue Sun Silin Pan 《Journal of Interventional Medicine》 2022年第4期196-199,共4页
Objective:This study aimed to analyze and evaluate the results of mid-term follow-up after fetal pulmonary valvuloplasty(FPV)in fetuses with pulmonary atresia with intact ventricular septum(PA/IVS).Methods:From August... Objective:This study aimed to analyze and evaluate the results of mid-term follow-up after fetal pulmonary valvuloplasty(FPV)in fetuses with pulmonary atresia with intact ventricular septum(PA/IVS).Methods:From August 31,2018,to May 31,2019,seven fetuses with PA/IVS and hypoplastic right heart were included in this study.All underwent echocardiography by the same specialist and were operated on by the same team.Intervention and echocardiography data were collected,and changes in the associated indices noted during follow-up were analyzed.Results:All seven fetuses successfully underwent FPV.The median gestational age at FPV was 27.54 weeks.The average FPV procedural time was 6 min.Persistent bradycardia requiring treatment occurred in 4/7 procedures.Finally,five pregnancies were successfully delivered,and the other two were aborted.Compared to data before fetal cardiac interventions(FCI),tricuspid valve annulus diameter/mitral valve annulus diameter(TV/MV)and right ventricle diameter/left ventricle diameter(RV/LV)of all fetuses had progressively improved.The maximum tricuspid regurgitation velocity decreased from 4.60 m/s to 3.64 m/s.The average follow-up time was 30.40±2.05 months.During the follow-up period,the diameter of the tricuspid valve ring in five children continued to improve,and the development rate of the tricuspid valve was relatively obvious from 6 months to 1 year after birth.However,the development of the right ventricle after birth was relatively slow.It was discovered that there were individual variations in the development of the right ventricle during follow-up.Conclusion:The findings support the potential for the development of the right ventricle and tricuspid valve in fetuses with PA/IVS who underwent FCI.Development of the right ventricle and tricuspid valve does not occur synchronously during pregnancy.The right ventricle develops rapidly in utero,but the development of tricuspid valve is more apparent after birth than in utero. 展开更多
关键词 Congenital heart disease fetal cardiac intervention fetal pulmonary valvuloplasty hypoplastic right heart syndrome pulmonary atresia with intact septum
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The Clinical Application Value of Selective Unifocalization in the Treatment of Severe Pulmonary Artery Atresia with Ventricular Septal Defect
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作者 Jinyang Liu Bo Peng +5 位作者 Xianchao Jiang Simeng Zhang Jiachen Li Lizhi Lv Qiang Wang Xiang Li 《Congenital Heart Disease》 SCIE 2021年第1期65-71,共7页
Background:This study aims to explore the efficacy of selective unifocalization(UF)for major aortopulmonary collateral arteries(MAPCAs)unifocalization in children with pulmonary atresia with ventricular septal defect(... Background:This study aims to explore the efficacy of selective unifocalization(UF)for major aortopulmonary collateral arteries(MAPCAs)unifocalization in children with pulmonary atresia with ventricular septal defect(PA/VSD).Methods:A retrospective analysis of 13 patients with PA/VSD/MAPCAs who underwent surgery from June 2017 to December 2019.Sex,age,preoperative cardiovascular angiography test results and McGoon ratio were collected.The properties of the collateral arteries were evaluated by angiography,and selective UF for the“dendritic”MAPCAs and ligation of MAPCAs demonstrating distortion and resistance.Results:A total of 13 severe patients underwent one-stage repair,of which 1 case underwent ventricular septal fenestration and died after 2 weeks of ECMO support.The median age was 37 months,and a median weight was 14.0 kg.A right ventricular to aortic systolic pressure ratio(pRV/pAo)of no more than 0.5 was achieved in 12 living patients.Conclusion:Selective unifocalization based on MAPCAs morphology can achieved a good outcome at the early stage.This surgical concept might be provided a novel insight into treatment for some of the subgroups presenting with this complex form of PA/VSD/MAPCAs. 展开更多
关键词 pulmonary atresia major aortopulmonary collateral arteries selective unifocalization
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Fresh Pericardial Valved Conduit for Reconstruction of Right Ventricular Outflow Tract in Tetralogy of Fallot with Pulmonary Stenosis or Pulmonary Atresia—Early Results
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作者 Anurag Agarwal Akshay Chauhan +3 位作者 Nayem Raja Chirantan Mangukia Saket Aggarwal Deepak Kumar Satsangi 《World Journal of Cardiovascular Surgery》 2017年第2期16-25,共10页
Objective: To study early results of hand made fresh (autologous/homologous) pericardial valved conduit in achieving right ventricle to pulmonary artery continuity. Method: Between November 2014 and September 2015, 19... Objective: To study early results of hand made fresh (autologous/homologous) pericardial valved conduit in achieving right ventricle to pulmonary artery continuity. Method: Between November 2014 and September 2015, 19 cases, with diagnosis of Tetralogy of Fallot with Pulmonary stenosis (PS) or Pulmonary atresia (PA) underwent intracardiac repair and Right Ventricular Outflow Tract (RVOT) reconstruction with hand made fresh [autologous (n = 2)/ homologous (n = 17)] pericardial valved conduit. Mean age of the patients at time of surgery was 6.37 years (range 3 months to 18 years), mean weight was 18.52 kilograms (range 6 kg to 40 kg) and mean size of the conduit was 20.7 mm (range 16 mm to 24 mm). Results: All patients had a smooth post-operative course, with mean ICU (Intensive Care Unit) stay of 3.6 days (range 3 days to 6 days) and mean post-operative hospital stay 8.5 days (range 7 days to 16 days). Intra-operative and Post-operative echocardiography revealed moderate Pulmonary regurgitation (PR) in one patient, mild PR in 5 patients and no or trace PR in 13 patients. No patient has developed conduit stenosis or calcification till now. Conclusion: Autologous or homologous pericardial valved conduit provides good early results and is especially suitable for developing world because of zero cost. Long term usefulness of such option remains to be confirmed in terms of dilation, calcification and freedom from intervention. 展开更多
关键词 RV-pa (Right Ventricle-pulmonary Artery) CONTINUITY Tetralogy of Fallot PERICARDIAL Valved CONDUIT
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Hybrid procedure for pulmonary atresia with intact ventricular septum
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作者 李守军 《外科研究与新技术》 2011年第3期189-189,共1页
Objective In patients with pulmonary atresia and intact ventricular septum (PAIVS) without right ventricular-dependent coronaries,catheter techniques including the use of a sniff wire,lasers,and radiofrequency have be... Objective In patients with pulmonary atresia and intact ventricular septum (PAIVS) without right ventricular-dependent coronaries,catheter techniques including the use of a sniff wire,lasers,and radiofrequency have been the most widely used as initial therapy. However,percutaneous perforation and balloon valvuloplasty were associated with higher rate of procedural failure and 展开更多
关键词 PDA Hybrid procedure for pulmonary atresia with intact ventricular septum
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新生儿室间隔完整型肺动脉闭锁治疗结果
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作者 陶曙光 姚俊平 +4 位作者 谷疆蓉 杨仕海 温林林 金立臣 高伟 《河北医药》 CAS 2024年第16期2436-2441,共6页
目的 总结室间隔完整型肺动脉闭锁患儿的治疗经验。方法 回顾性分析2017年1月至2023年1月收治的16例新生儿室间隔完整型肺动脉闭锁临床资料,男9例,女7例;日龄4 h~25 d;入院体重1.6~4 kg,平均(3.22±0.65) kg。所有患儿初期治疗后进... 目的 总结室间隔完整型肺动脉闭锁患儿的治疗经验。方法 回顾性分析2017年1月至2023年1月收治的16例新生儿室间隔完整型肺动脉闭锁临床资料,男9例,女7例;日龄4 h~25 d;入院体重1.6~4 kg,平均(3.22±0.65) kg。所有患儿初期治疗后进行随访,随访时间3个月至6年,中位随访时间33(12,55)月。初期治疗措施包括以下术式:体外循环下房间隔扩大、B-T分流、镶嵌治疗、非体外下经胸肺动脉瓣切开术等,每例患儿选择一种或者多种组合术式。结果 患儿院内死亡1例,院外无死亡病例。再次治疗6例,其中行经导管肺动脉瓣球囊扩张成形术5例,行双向Glenn术1例。其余9例患儿术中后已5年1例,经皮血氧饱和度>95%,房间隔转为左向右分流,远期免于再干预,其余患儿仍在随访中,存在再次干预可能。首次根治后1个月较大的肺动脉根部直径远期行双心室根治可能性大。结论 室间隔完整型肺动脉闭锁是需要序贯性治疗和观察的疾病,为获得较好的生存质量,初次治疗应依据右心室发育程度选择个性化措施,然后密切主动随访,适时给予再次治疗。 展开更多
关键词 室间隔完整型肺动脉闭锁 新生儿 镶嵌治疗 外科治疗 随访
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宫内心脏介入治疗胎儿危重型先天性心脏病5例报告
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作者 蔡蕾裔 赵莉晴 +7 位作者 王磊 焦先婷 张拥军 武育蓉 朱泓 夏红萍 孙锟 陈笋 《临床儿科杂志》 CAS CSCD 北大核心 2024年第1期35-39,共5页
目的探索胎儿心脏介入治疗(FCI)对于胎儿危重型先天性心脏病的可行性及短期疗效。方法纳入2018年8月至2022年5月在宫内诊治中心进行FCI的所有患儿的临床资料,包括围产期至出生后基本信息、FCI手术信息、胎儿超声心动图信息等,追踪病例... 目的探索胎儿心脏介入治疗(FCI)对于胎儿危重型先天性心脏病的可行性及短期疗效。方法纳入2018年8月至2022年5月在宫内诊治中心进行FCI的所有患儿的临床资料,包括围产期至出生后基本信息、FCI手术信息、胎儿超声心动图信息等,追踪病例至出生后3月,分析FCI技术的可行性、有效性及安全性。结果纳入胎儿7例,其中5例实施FCI手术,手术成功率100%(5/5),包括2例重度主动脉瓣狭窄(CAS)和3例室间隔完整型肺动脉闭锁(PA/IVS)。手术时的中位孕周为29^(+2)(28^(+6)~32^(+4))周。5例胎儿FCI术后的超声心动图指标均获得明显改善。5例胎儿均足月出生,中位出生胎龄39^(+2)(38~39^(+4))周。生后2例CAS患儿行外科主动脉瓣成形术,3例PA/IVS患儿完成经皮肺动脉瓣球囊扩张术。1例心功能不全CAS患儿于新生儿期死亡,4例随访中,预后良好。结论FCI是一项安全、有效的技术,有望改善危重型先天性心脏病的预后。 展开更多
关键词 胎儿心脏介入治疗 主动脉瓣狭窄 室间隔完整型肺动脉闭锁 先天性心脏病
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HD-Flow联合STIC在胎儿肺动脉闭锁合并室间隔缺损诊断中的应用价值
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作者 吴温瑞 李天刚 +4 位作者 马斌 燕志恒 王瑷琳 韩苗苗 杨天顺 《中国临床医学影像杂志》 CAS CSCD 北大核心 2024年第5期351-354,共4页
目的:探讨高分辨率血流成像(HD-Flow)联合时间-空间复合成像(STIC)诊断胎儿肺动脉闭锁合并室缺(PA-VSD)的临床价值。方法:分析经胎儿超声心动图诊断的44例PA-VSD胎儿心脏二维、HD-Flow联合STIC图像,评估HD-Flow联合STIC在PA-VSD不同分... 目的:探讨高分辨率血流成像(HD-Flow)联合时间-空间复合成像(STIC)诊断胎儿肺动脉闭锁合并室缺(PA-VSD)的临床价值。方法:分析经胎儿超声心动图诊断的44例PA-VSD胎儿心脏二维、HD-Flow联合STIC图像,评估HD-Flow联合STIC在PA-VSD不同分型诊断中的效能,并探讨PA-VSD胎儿动脉导管内径与左、右肺动脉内径相关性。结果:HD-Flow联合STIC诊断44例PA-VSD,其中A型42例,C型2例。HD-Flow联合STIC能够清晰显示胎儿肺动脉及其分支血管及动脉导管血流;Pearson相关性分析表明A型动脉导管内径和左、右肺动脉内径均呈正相关(r=0.507、0.404,P<0.01)。结论:HD-Flow联合STIC能够明确诊断PA-VSD并分型,有较大的临床应用价值,A型PA-VSD胎儿动脉导管内径与左、右肺动脉内径存在正相关。 展开更多
关键词 肺动脉瓣闭锁 胎儿 室间隔缺损 超声检查 多普勒 彩色
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法洛四联症合并肺动脉闭锁的先天性心脏病1例并文献复习
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作者 邹明锐 董圣军 +1 位作者 刘宝辉 王玉玖 《国际医药卫生导报》 2024年第12期2053-2055,共3页
法洛四联症(TOF)是最常见的紫绀型先天性心脏病,肺动脉闭锁(PA)也是一种较为复杂的先天性心脏畸形。本文对滨州医学院附属医院收治的1例TOF合并PA的先天性心脏病进行报道,手术方案采用外科生物补片进行肺动脉瓣的重建,缝至右心室切口到... 法洛四联症(TOF)是最常见的紫绀型先天性心脏病,肺动脉闭锁(PA)也是一种较为复杂的先天性心脏畸形。本文对滨州医学院附属医院收治的1例TOF合并PA的先天性心脏病进行报道,手术方案采用外科生物补片进行肺动脉瓣的重建,缝至右心室切口到原肺动脉瓣处以抗肺动脉瓣反流,最后总结TOF/PA的临床表现、影像诊断、手术方案及未来的治疗前景等。 展开更多
关键词 法洛四联症 肺动脉闭锁 肺动脉瓣重建 手术方案
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PA-MSHA疫苗对严重创伤患者并发肺部感染的预防作用 被引量:7
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作者 单红卫 林兆奋 +2 位作者 赵良 杨兴易 袁郑 《中国急救医学》 CAS CSCD 北大核心 2007年第4期375-377,共3页
目的研究绿脓杆菌菌毛株(PA-MSHA)疫苗对严重创伤患者免疫功能影响和对并发肺部感染的预防作用。方法选择ICU住院严重创伤患者共55例,随机分为两组:①对照组:27例,给予常规治疗;②疫苗组:28例,除常规救治外,从入院当天给予皮下注射PA-M... 目的研究绿脓杆菌菌毛株(PA-MSHA)疫苗对严重创伤患者免疫功能影响和对并发肺部感染的预防作用。方法选择ICU住院严重创伤患者共55例,随机分为两组:①对照组:27例,给予常规治疗;②疫苗组:28例,除常规救治外,从入院当天给予皮下注射PA-MSHA疫苗1.0 mL,1次/d,连续注射14 d。分别在入院当天和入院第14天取静脉血测定免疫功能指标,并统计入院第14天内并发肺部感染的发生率。结果疫苗组在入院第14天时血清IgG、补体C3和C4、NK(自然杀伤细胞)活性、CD3、CD4和CD4/CD8比值均比入院当天有明显升高(P<0.01),而对照组仅有补体C3值在入院第14天出现明显升高(P<0.05);对照组在入院第14天内并发肺部感染发生率为44.4%,疫苗组为21.4%,疫苗组肺部感染发生率明显低于对照组(P<0.01)。结论PA-MSHA疫苗能够明显提高严重创伤患者机体免疫功能,并且能一定程度预防肺部感染的发生率。 展开更多
关键词 pa-MSHA疫苗 免疫功能 肺部感染 严重创伤
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CRP、PA在COPD急性发作期的临床意义 被引量:8
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作者 刘晓俊 杨恂 《现代临床医学》 2006年第4期302-305,共4页
关键词 COPD 急性发作期 临床意义 慢性呼吸系统疾病 CRP pulmonary 阻塞性肺部疾病 慢性炎症性疾病 pa 社会经济负担
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复方葶苈注射液对肺心病急性发作期t-PA、PAI活性的影响 被引量:3
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作者 赵敏 赵辉 戎装 《中国中医急症》 2004年第1期7-8,共2页
目的观察复方葶苈注射液对肺心病急性发作期纤溶活性的影响。方法(1)临床观察部分:将肺心病急性发作期患者随机分为治疗组与对照组,治疗组予复方葶苈注射液,对照组予酚妥拉明,观察两组治疗后t-PA及PAI活性的变化;(2)动物实验部分:将大... 目的观察复方葶苈注射液对肺心病急性发作期纤溶活性的影响。方法(1)临床观察部分:将肺心病急性发作期患者随机分为治疗组与对照组,治疗组予复方葶苈注射液,对照组予酚妥拉明,观察两组治疗后t-PA及PAI活性的变化;(2)动物实验部分:将大鼠随机分为中药组(予复方葶苈注射液)、西药组(予酚妥拉明)、模型组(予生理盐水)和空白对照组(予生理盐水),造模后分别予相应药物(空白对照组不造模),观察大鼠组织型纤溶酶原激活物(t-PA)及纤溶酶原激活物抑制物(PAI)活性的改变。结果复方葶苈注射液升高t-PA活性、降低PAI活性的作用与酚妥拉明相近。结论复方葶苈注射液可改善肺心病急性发作期患者纤溶活性。 展开更多
关键词 复方葶苈注射液 肺心病 急性发作期 t-pa paI 动物实验 纤溶活性
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肺动脉闭锁根治及体肺侧支融合患儿的术后护理
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作者 李晓艳 李冉 +1 位作者 唐晓敏 李帅妮 《中华急危重症护理杂志》 CSCD 2024年第9期840-842,共3页
总结1例行肺动脉闭锁根治及体肺侧支融合患儿的术后护理体会。针对患儿手术操作复杂、体外循环时间长、术后右心室顺应性差、应用人工带瓣血管、延迟关胸等问题,采取严格控制出入量,维持右心功能稳定;做好早期动态抗凝管理,保持人工带... 总结1例行肺动脉闭锁根治及体肺侧支融合患儿的术后护理体会。针对患儿手术操作复杂、体外循环时间长、术后右心室顺应性差、应用人工带瓣血管、延迟关胸等问题,采取严格控制出入量,维持右心功能稳定;做好早期动态抗凝管理,保持人工带瓣血管通畅;重视延迟关胸及呼吸道护理;加强营养支持及心理护理等措施。经过精心治疗和护理,患儿康复出院。随访6个月,患儿右室流出道通畅,心功能恢复良好。 展开更多
关键词 肺动脉闭锁 室间隔缺损 体肺动脉侧支循环 危重病护理
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