改良布洛克-陶西分流术后肺动脉的变化:基于计算机断层扫描的分析

Q4 Medicine
Sangjun Lee, J. G. Kwak, Woong-Han Kim
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引用次数: 0

摘要

背景虽然改良布洛克-陶西分流术仍是各种先天性心脏病增加肺血流量的主要姑息方法,但分流术必须经过精心设计才能达到最佳效果。本研究探讨了分流管配置对肺动脉生长和生长差异的影响。方法分析了20例成功取出改良Blalock-Taussig分流管的患者。通过计算机断层扫描获得了肺动脉和分流管的特征。计算同侧和对侧动脉的基线直径比和随访直径比以及生长的差异。测量了分流道与肺动脉之间的角度以及与主肺动脉分叉的距离。分析了肺动脉与分流管配置之间的相关性。结果从分流管置入到取出的中位间隔时间为 154.5 天(四分位间范围为 113.25-276.25 天)。同侧与对侧肺动脉直径比的随访值与分流角度(ρ=0.429,p=0.126)或距离(ρ=0.110,p=0.645)无显著相关性。分流角和主肺动脉分叉的距离无明显相关性(ρ=-0.373,p=0.189)。肺动脉生长与分流角度呈负相关(同侧,ρ=-0.565,P=0.035;对侧,ρ=-0.578,P=0.030),但与距离无关(同侧,ρ=-0.065,P=0.786;对侧,ρ=-0.130,P=0.586)。分流管的角度和距离与生长失衡无明显相关性。更垂直的分流与肺动脉明显增长有关。我们建议采用更垂直的移植物设计来改善肺动脉生长。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Change in Pulmonary Arteries after Modified Blalock-Taussig Shunt Procedure: Analysis Based on Computed Tomography.
Background Although the modified Blalock-Taussig shunt remains the mainstay method of palliation for augmenting pulmonary blood flow in various congenital heart diseases, the shunt must be carefully designed to achieve the best outcomes. This study investigated the effect of shunt configuration on pulmonary artery growth and growth discrepancy. Methods Twenty patients with successful modified Blalock-Taussig shunt takedown were analyzed. Pulmonary artery and shunt characteristics were obtained using computed tomography scans. Differences in the baseline and follow-up diameter ratios and growth in the ipsilateral and contralateral arteries were calculated. The angle between the shunt and pulmonary artery, as well as the distance from the main pulmonary artery bifurcation, were measured. Correlations between pulmonary arteries and shunt configurations were analyzed. Results The median interval time between shunt placement and takedown was 154.5 days (interquartile range, 113.25-276.25 days). Follow-up values of the ipsilateral-to-contralateral pulmonary artery diameter ratio showed no significant correlation with the shunt angle (ρ=0.429, p=0.126) or distance (ρ=0.110, p=0.645). The shunt angle and distance from the main pulmonary bifurcation showed no significant correlation (ρ=-0.373, p=0.189). Pulmonary artery growth was negatively correlated with shunt angle (ipsilateral, ρ=-0.565 and p=0.035; contralateral, ρ=-0.578 and p=0.030), but not with distance (ipsilateral, ρ=-0.065 and p=0.786; contralateral, ρ=-0.130 and p=0.586). Conclusion Shunt configuration had no significant effect on growth imbalance. The angle and distance of the shunt showed no significant correlation with each other. A more vertical shunt was associated with significant pulmonary artery growth. We suggest a more vertical graft design for improved pulmonary artery growth.
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来源期刊
Journal of Chest Surgery
Journal of Chest Surgery Medicine-Surgery
CiteScore
0.80
自引率
0.00%
发文量
76
审稿时长
7 weeks
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