复杂先天性心脏病的镶嵌治疗.ppt

Interventional Cardiac Catheterization Combined with Cardiac Surgery for Complex Congenital Heart Disease Zhiwei Zhang, MD (张智伟) Guangdong Provincial Cardiovascular Institute The combined approach : A joint procedure involving intervention and surgery Staged therapy for complex disease Proven clinical effectiveness and safety Some procedures even become the standard treatment for specific congenital heart disease Transcatheter intervention before surgery Intraoperative transcatheter intervention (Hybrid approach) Transcatheter intervention after surgery Transcatheter Intervention before surgery Transcatheter atrial septostomy Aortopulmonary collateral arteries occlusion Aortopulmonary shunt occlusion Radiofrequency or Laser-assisted pulmonary valvotomy and balloon valvuloplasty Transcatheter atrial septostomy TGA/IVS HLHS 、MA HRHS、TA PA/IVS TAPVC BAS Atrial septostomy in a fetus with HLHS Aortopulmonary collateral arteries occlusion before operation Occlusion of collaterals in a TOF case with RVOT reconstruction and 2 days later the case underwent surgical total correction Radiofrequency or Laser-assisted pulmonary valvotomy and balloon valvuloplasty PA/IVS Early establishment of continuity between the right ventricle with pulmonary trunk Decompressive the hypertensive right ventricle Promote growth of right ventricle Radiofrequency or Laser-assisted pulmonary valvotomy and balloon valvuloplasty As alternative to surgical treatment Effective in establishing RV-PA continuity Much lower immediate mortality and morbidity Improved outcome 图片 电影 Intraoperative transcatheter intervention Intraoperative stenting of pulmonary arteries or veins Ventricular device closure of muscular ventricular septal defects Percutaneous approach to completion of total cavopulmonary connection or the Fontan circuit Hybrid approach in the treatment of hypoplastic left heart syndrome Intraoperative Stenting of Branch Pulmonary Arteries Limitations of Stent Implantati