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3) 小児期心疾患に対するカテーテル治療(シンポジウム 血管内手術 : 各科領域における現状, 第483回新潟医学会)

フォーマット:
論文(リポジトリ)
責任表示:
佐藤, 勇 ; 塚野, 真也 ; 福島, 英樹 ; 佐藤, 誠一 ; 内山, 聖
出版情報:
新潟医学会, 1994-02
掲載情報:
新潟医学会雑誌 = 新潟医学会雑誌
ISSN:
00290440  CiNii Articles  Webcat Plus  JAIRO
著者名:
巻:
108
通号:
2
開始ページ:
106
終了ページ:
114
バージョン:
publisher
概要:
Interventional cardiac catheterization was attempted in forty-two patients with various types of congenital heart disease. Balloon atrial septostomy (BAS) was the first major therapeutic technique utilized during pediatric cardiac catheterization. Transposition of the great arteries was the most common indication, but with the advancement of the surgical procedure, BAS was rarely utilized in newborn infants. Catheter balloon angioplasty was performed in nine patients (aged 1 month to 15 years). We reported successful dilatation of a stenotic Blalock-Taussing shunt in 2 cases. There was an improvement in cyanosis, and pathological analysis revealed linear wall stress at the site of inflation. Three children underwent balloon angioplasty for native coarctation. The narrowest portion of the coarctation is measured from the aortogram and a catheter with a balloon 2.5 to 3 times the diameter of the narrowest portion is selected. The maximum size of the balloon diameter was as same as the diameter of the aorta at the site of diaphragm. Using double balloon method, the systolic pressure difference across the coarctation fell down effectively in all patients. We reported on the acute results for pulmonary valvuloplasty in eleven patients (aged 19 days to 8 years). In early two cases, single balloon technique was performed, next two cases double balloon technique was selected. Two balloons can be inflated and deflated more rapidly than a single balloon of equivalent effective diameter. In recent cases, “Inoue balloon” was selected because of rapid deflation and effective splitting of fused commissures. The peak systolic pressure difference across the pulmonary valve fell from 56.9±14.5 mmHg to 27.7±10.7 mmHg. In our experience, balloon valvuloplasty was successful in infant with critical pulmonary stenosis. It is certainly a therapeutic option in these seriously ill, cyanotic newborns. 続きを見る
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