重症法洛四联症矫正术前应用体肺侧支血管栓塞术的价值

目的：评价体肺侧支血管栓塞术在重症法洛四联症矫正术中的应用价值。方法：经心血管造影证实诊断的5例成年重症法洛四联症病人，在施行外科心内畸形矫正术当天先送导管室，行体肺侧支血管栓塞术。结果：造影发现体肺侧支血管16支，对其中的12支（75％）侧支血管进行了成功栓塞，共用弹簧栓子18枚。外科术中术野显露较好，回血量不多，体外循环灌注压稳定。术后4例痊愈，1例因左心室重度发育不良而死于低心输出量综合征。结论：对伴有丰富侧支血管形成的复杂紫绀性先天性心脏畸形病人，在外科矫正术前通过造影指导下栓堵体肺侧支血管，可简化手术过程，减少因手术野限制结扎体肺侧支血管的困难，提高手术成功率。

Application of transcatheter aortopulmonary collateral vessels embolization in patients with severe tetralogy of Fallot

Objective: To evaluate the efficacy of transcatheter aortaopulmonary collateral vessels embolization in patients with severe tetralogy of Fallot. Methods: The transcatheter aortopulmonary collateral vessels embolization was performed in 5 adult patients with severe tetralogy of Fallot confirmed by angiography who would undergo cardiac surgical correction immediately after the procedure. Results: 16 aortopulmonary collateral vessels were found by angiography, 12 of which (75%) were occluded successfully with 18 coil embolus. Blood flow from collateral vessels was low and operation field was clear during cardiac surgery. Arterial pressure was kept stable during extracorporeal circulation. 4 patients recovered completely. 1 patient with severe dysplasia of left ventricle died of low cardiac output syndrome. Conclusion: For patients with complicated cyanotic congenital heart disease and rich aortopulmonary collaterals. Right before cardiac surgery, transcatheter aortopulmonary collateral vessels embolization may be considered improve the outcome of operation.