先心病外科残留病变的介入治疗-英文课件PPT.ppt

Branch Pulmonary Artery Stenosis  Stent Implantation Branch Pulmonary Artery Stenosis Post-implantation of Endovascular Stent Li YC M/15 years right atrial isomerism, atrioventricular septal defect, pulmonary atresia, left pulmonary artery stenosis Right modified BT shunt in neonatal period left modified BT shunt at 3 year old Extracardiac conduit Fontan operation at 8 year of age Balloon Angioplasty for Branch Pulmonary Artery Stenosis after Fontan operation R cavopulmonary connection L cavopulmonary connection PA stenosis after Fontan operation Balloon dilation of PA stenosis Fenestration after Fontan Operation :Transcatheter Occlusion Transcatheter Occlusion of Fenestrations after Fontan Operation Decrease systemic-venous pressure in high risk patients (e.g. high pre-operative mean PA pressure) Improve cardiac output Decrease pleural effusion Decrease Fontan failure rate Fenestration - Short-term post-operative benefits : F/7 , Post fenestrated extracardiac Fontan at 5 years old Contrast Injection in the Extracardiac Conduit Transcatheter Occlusion of Fenestrations after Fontan Operation Spontaneous closure usually does not occur Right to left shunting ? cyanosis, impaired exercise capacity, paradoxical embolisation, Fenestration - Disadvantages: Device : Amplatzer Septal Occluder Test balloon occlusion of the fenestration to ensure maintenance of systemic blood pressure and cardiac output and absence of significant elevation of systemic-venous pressure Transcatheter Occlusion of Fontan Fenestrations : 先心病外科殘留病變的介入治療 周啟東 醫生 翁德璋 醫生 香港大学葛量洪医院小儿心脏科 Division of Paediatric Cardiology, Grantham Hospital Department of Paediatrics and Adolescent Medicine, The University of Hong Kong The 10th South China International Congress of Cardiology 第十屆中國南方國際心血管病學術會議 Complexity of congenital heart operation varies widely Simple Ducts arteriosus ligation Atrial septal defect closure Ventricular septal defect closure Moderat