复杂性先天性心脏病双向Glenn术后血管造影分析

目的 采用血管造影评价复杂性先天性心脏病双向Glenn术后肺动脉发育及相关解剖学变化. 方法 回顾性分析32例复杂性先天性心脏病双向Glenn术后患者血管造影资料,且22例与术前造影资料比较,评价肺动脉发育、上腔静脉-肺动脉吻合口、主动脉侧支血管及并发症等情况. 结果 31例上腔静脉-肺动脉吻合口通畅,1例吻合口狭窄疑血栓形成.28例肺动脉发育良好且左、右肺动脉发育对称,3例单侧肺动脉狭窄,1例肺动脉发育差.1例出现肺动静脉瘘,1例存在胸腔积液.22例双向Glenn手术前后造影比较,左右肺动脉直径和McGoon率变化差异有统计学意义;36.36%(8/22)的主动脉侧支较术前增多.18.75%(6/32)病例术后存在腔静脉侧支血管. 结论血管造影是评价复杂性先天性心脏病双向Glenn术后肺动脉发育及相关解剖学情况的有效手段.

Angiography of the complex congenital heart disease after Bi-directional Glenn procedure

Objective To investigate the changes of the pulmonary artery and coherent anatomies after Bi-directional Glenn procedure with angiography. Methods Angiography data of 32 complex congenital heart disease patients underwent Bi-directional Glenn procedure were retrospectively analyzed. Changes of pre-surgery and post-surgery of 22 patients were compared, including pulmonary artery, cavopulmonary anastomotic stoma, main aorto-pulmonary collateral arteries (MAPCA) and complications. Results Of all 32 patients, 31 cavopulmonary anastomotic stomas were clear and smooth, 1 was stenosis with suspected thrombus; 28 pulmonary arteries were well-developed and bilateral symmetry, 3 were uni-lateral stenosis, 1 was poor-developed. Pulmonary arteriovenous fistula and pleural effusion was detected in 1 patient respectively. Changes of pulmonary artery size and McGoon rate were significant between pre-surgery and post-surgery: MAPCA increased post-surgery in 36.36% (8/22), while 18.75% (6/32) superior cavo-pulmonary collateral arteries occurred after Glenn procedure. Conclusion Angiography can accurately display the changes of the pulmonary artery and coherent anatomies after Bi-directional Glenn procedure.