Dietmar Schranz, Hakan Akintuerk, Michael Huebler, Jelena Pabst von Ohain, Anoosh Esmaeili, Nora Lang, Rainer Kozlik-Feldmann, Gunter Kerst
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Norwood手术是左心发育不全综合征(HLHS)新生儿的第一种治疗方法,通过随后的Fontan循环使其存活。此后不久,心脏移植作为双心室替代方案出现。吉森混合方法是针对高诺伍德死亡率而开发的,即使对高风险的HLHS患者也提供了生存机会。基于令人信服的hybrid结果,一些中心取代了复杂的新生儿诺伍德手术。与北美的方法不同,Giessen Hybrid将外科肺分支绑扎术与经皮导管支架置入相结合,旨在发展为完全经皮的1期手术(S1P)。指定的经导管S1P,被称为“DIDI”(双重意图,双重干预),作为放置肺限流器(PFRs)的双重干预,随后对导管依赖全身血流的新生儿进行导管支架置入,旨在实现“No Norwood, No Hybrid”策略。随着ce批准的用于导管支架的镍钛诺支架和经导管肺限流器(PFRs)的发展,这一点变得可行,甚至适用于新生儿。最近的进展使新生儿能够安全地使用PFRs,通过4和5 Fr标准诊断导管手动操作ce批准的微血管塞。虽然标签外,但其在新生儿经导管S1P中的可行性和有效性是显而易见的。现在各种机构都在进行经导管S1P,技术上略有不同。我们的方法使S1P几乎无伤性选择新生儿严重的左心室梗阻。来自德国的专家对27例新生儿采用“No Norwood, No Hybrid”策略(包括经皮肺动脉束带和导管支架置入术)治疗的经验进行了批判性回顾。
期刊介绍:
Seminars in Thoracic and Cardiovascular Surgery is devoted to providing a forum for cardiothoracic surgeons to disseminate and discuss important new information and to gain insight into unresolved areas of question in the specialty. Each issue presents readers with a selection of original peer-reviewed articles accompanied by editorial commentary from specialists in the field. In addition, readers are offered valuable invited articles: State of Views editorials and Current Readings highlighting the latest contributions on central or controversial issues. Another prized feature is expert roundtable discussions in which experts debate critical questions for cardiothoracic treatment and care. Seminars is an invitation-only publication that receives original submissions transferred ONLY from its sister publication, The Journal of Thoracic and Cardiovascular Surgery. As we continue to expand the reach of the Journal, we will explore the possibility of accepting unsolicited manuscripts in the future.