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ID 49927
フルテキストURL
著者
Ohno, Naoki Okayama Univ, Dept Pediat, Grad Sch Med Dent & Pharmaceut Sci
Ohtsuki, Shinichi Okayama Univ, Dept Pediat, Grad Sch Med Dent & Pharmaceut Sci
Kataoka, Koichi Okayama Univ, Dept Pediat, Grad Sch Med Dent & Pharmaceut Sci
Baba, Kenji Okayama Univ, Dept Pediat, Grad Sch Med Dent & Pharmaceut Sci
Okamoto, Yoshio Okayama Univ, Dept Pediat, Grad Sch Med Dent & Pharmaceut Sci
Kondo, Maiko Okayama Univ, Dept Pediat, Grad Sch Med Dent & Pharmaceut Sci
Sano, Shunji Okayama Univ, Dept Cardiovasc Surg, Grad Sch Med Dent & Pharmaceut Sci
Kasahara, Shingo Okayama Univ, Dept Cardiovasc Surg, Grad Sch Med Dent & Pharmaceut Sci
Honjo, Osami Okayama Univ, Dept Cardiovasc Surg, Grad Sch Med Dent & Pharmaceut Sci
Morishima, Tsuneo Okayama Univ, Dept Pediat, Grad Sch Med Dent & Pharmaceut Sci
抄録
Objective We sought to evaluate the efficacy of balloon angioplasty (BA) for severely desaturated patients due to a stenotic right ventricle (RV) to pulmonary artery (PA) shunt following modified Norwood procedure. Methods Of 87 patients who underwent a Norwood procedure with the RV-PA shunt between February 1998 through March 2010, 22 (25%) patients underwent BA. The efficacy of BA was assessed by angiographic measurement of the changes in the internal diameters of the stenotic portions of the shunt, changes in arterial saturation and clinical outcomes. Results BA was performed for stenotic RV-PA shunts following stage I palliation (n = 17, 77%), or those placed as an additional blood source (n = 5, 23%, 3 patients awaiting biventricular repair, 2 patients following stage II palliation). The location of the BA was at the distal anastomosis in 12 (54.5%), proximal anastomosis in 21 (95.4%) and in the mid-portion of the shunt in 11 (50%) cases. The diameters of these three shunt portions were measured from the anteriorposterior and lateral angiographic images, increasing significantly after BA (p < 0.0001) in all. Arterial saturation significantly improved after BA in all cases (66.5 +/- 4.3% to 79.4 +/- 3.4%, p < 0.0001). Freedom from reintervention was 100%. All patients underwent subsequent elective planned surgery at an appropriate age with no mortality. Conclusions A BA-alone strategy for a stenotic RV-PA shunt was effective for all three shunt portions, minimizing shunt-related premature surgical intervention.
キーワード
balloon angioplasty
rv-pa shunt
hypoplastic left heart syndrome
Norwood
発行日
2013-04
出版物タイトル
Catheterization and Cardiovascular Interventions
81巻
5号
開始ページ
837
終了ページ
842
ISSN
1522-1946
資料タイプ
学術雑誌論文
オフィシャル URL
http://dx.doi.org/10.1002/ccd.24576
関連URL
http://ousar.lib.okayama-u.ac.jp/metadata/49738
言語
English
OAI-PMH Set
岡山大学
著作権者
(c) 2012 Wiley Periodicals, Inc.
論文のバージョン
author
査読
有り
DOI
Web of Sience KeyUT