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41.
42.
T. Akagi K. Hashino Y. Maeno M. Ishii T. Sugimura T. Kawano H. Kato 《Pediatric cardiology》1997,18(1):61-63
Using a commercially available 5F deflectable radiofrequency catheter, we have succeeded in percutaneous valvotomy of an
imperforate pulmonary valve and consecutive balloon dilatation in a baby with pulmonary atresia and intact ventricular septum.
After the procedure, right ventricular systolic pressure fell from 125 mmHg to 65 mmHg, and right ventriculography demonstrated
anterograde blood flow into the pulmonary arteries. There were no major complications. Doppler echocardiography at 1 year
after the procedure demonstrated a pressure gradient across the pulmonary valve of 20 mmHg with mild pulmonary and tricuspid
regurgitations. 相似文献
43.
In neonates with pulmonary atresia and intact ventricular septum the aims of therapy are maintenance of pulmonary blood flow
and right ventricular decompression in order to achieve right ventricular support of the pulmonary circulation. Recent developments
in interventional heart catheterization with pulmonary radiofrequency-assisted balloon valvuloplasty and ductal stent implantation
offer an alternative to the classical surgical approach. We report on a neonate with membranous pulmonary atresia and intact
ventricular septum, in whom a large interatrial right-to-left shunt via the foramen ovale persisted after radiofrequency-assisted
pulmonary balloon valvuloplasty on the 2nd day of life. The interatrial shunt prevented adequate right ventricular filling
and antegrade pulmonary perfusion leading to severe cyanosis (transcutaneous oxygen saturation 40%). In order to increase
pulmonary blood flow and raise left atrial pressure, the arterial duct was stented. After ductal stenting, prostaglandin was
discontinued and the transcutaneous oxygen saturation remained stable around 89%. At follow up after 7 weeks the foramen ovale
had decreased in size and only a small left-to-right shunt was present, documenting the effectiveness of this approach.
Conclusion Based on the present case we propose a stepwise interventional approach for the neonate with pulmonary atresia and intact
ventricular septum. If cyanosis persists after isolated pulmonary valvuloplasty despite adequate right ventricular function,
ductal stent implantation can reduce interatrial shunting and thus improve oxygen saturation.
Received: 12 January 1998 / Accepted: 15 February 1998 相似文献
44.
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Intravascular ultrasound (IVUS) imaging provides useful additional information to X-ray angiography in selected cases of
balloon angioplasty and stent placement with complex vascular anatomy and unclear findings at angiography. It facilitates
accurate measurements of the vessel dimensions and reveals the extent of the disease for the selection of proper angioplasty
balloon size, as well as confirms full expansion and attachment of the stent or stent graft to the arterial wall. Intravascular
US imaging contributes useful information for the basis of planning surgical or endovascular therapy of aortic dissection
and is valuable for guiding percutaneous fenestration of the dissection flap. This imaging modality facilitates placement
of vena cava filter without cavography and/or fluoroscopy in patients with contraindication for iodine contrast media and/or
X-ray fluoroscopy. Technical development may further increase utility of IVUS imaging in interventional radiology.
Received: 22 May 2000; Accepted: 7 June 2000 相似文献
47.
目的 制作兔颈动脉球囊损伤后再狭窄模型 ,观察兔颈动脉球囊损伤后内膜增生的动态变化 ,探讨再狭窄的可能机制。方法 健康雄性家兔 40只 ,随机分为正常对照组 ( 10只 ) ,实验Ⅰ、Ⅱ、Ⅲ组 ,实验组行右颈总动脉血管成形术 ,并分别于术后第1、2和 4周处死实验Ⅰ、Ⅱ、Ⅲ组 ,第 4周同时处死对照组兔。光镜下观察内膜损伤后形态学变化 ,并进行图像分析。结果 与对照组比 ,实验组内膜面积呈持续性显著增加 (P <0 0 5 ,P <0 0 1) ,管腔面积从第 2周开始呈持续性显著减少 (P <0 0 1)。结论 兔颈动脉球囊损伤能较好的模拟再狭窄形成过程 ,球囊损伤后内膜增生是管腔狭窄的主要因素 相似文献
48.
目的:探讨双腔气囊小肠镜的内镜下球囊扩张(endoscopic balloon dilation,EBD)和狭窄切开(endoscopic
stricturotomy with needle knife,NKSt)对于小肠炎症性疾病相关狭窄治疗的安全性及有效性。方法:收集2015年7月至
2018年9月在中南大学湘雅三医院行双腔气囊小肠镜狭窄治疗的患者14例,病变部位16处,内镜下干预16次(EBD 11次
和NKSt 5次)。术后定期随访,观察患者的临床症状缓解和复发情况,以及是否能替代外科手术。结果:14例患者均
成功行内镜治疗,操作成功率100%,未发生穿孔、大出血等严重并发症。EBD和NKSt患者分别在随访5.9~35.3(中位
数26.1)个月及1.6~17.8(中位数8.3)个月内梗阻症状得到有效缓解,其中2例患者随访期间出现再次梗阻,予以保守对
症处理后缓解,未行外科手术干预。结论:小肠镜下治疗(EBD和NKSt)对小肠炎症性疾病狭窄安全有效,可以推迟
外科手术时间。 相似文献
49.
50.
The aim of this study is to provide decision support with artificial intelligence for tendon tissue engineering strategies. The experimental data of tissue-engineered tendons were integrated and standardized with a centralized database, and a decision support system was developed using both artificial neural networks and decision trees. The decision support system was trained with existing cases in the database, and then was used to generate tissue engineering schemes for new experimental animals. Following the schemes generated by the artificial intelligent system, we cured 28 of the 30 experimental animals. In conclusion, artificial intelligence is a powerful method for decision support in the tendon tissue engineering realm. 相似文献