The lung artery of special type is a narrow treatment _'s symptom

The lung artery of special type is a narrow treatment _'s symptom
The bad type lung artery one of development is narrow
It is one of the main reasons why PBPV postoperative result is bad that the bad type lung artery one of development is narrow, because its pathology changes the weight to differ, results that the sacculus expands are also inconsistent.
1.Diagnostic standard According to the intersection of heart and conduit and cardiovascular vessel radiography ' Or interesting Fig. of supersound) The manifestation checked, its diagnostic standard is as follows:
( 1) Lung the intersection of artery and petal it increases thick to be abnormality or the intersection of tubercle and form, the intersection of lung and the intersection of artery and petals of bad instead of take the form of curtain, carry the intersection of form and activity activity.
( 2) A ring is bad in development, smaller than the normal average.
( 3) Expand after not having or only narrow slightly. The above-mentioned three conditions exist, claim the bad type lung artery one of heavy-duty development is narrow. Have the intersection of lung and the intersection of artery and petals of development bad to behave leaf, diagnose one of condition or first the above person who will lack while being above-mentioned, the light, intermediate type bad type lung artery one of development is narrow.
2.The curative effect of shaping skill of the sacculus valve observes the bad type lung artery one of valve development narrowly and can be accompanied or not accompanied Noonan disease group, success rate is about 20-70%, about 14.3% of the patients will need to repeat PBPV in one year.
3.Influence the sacculus to expand a narrow sacculus of bad type lung artery of factor development of the skill result and expand the postoperative result and differ, relate to following factor:
( 1) Narrow severity and dissection characteristic: The bad type lung artery one of development is narrow, a leaf increases thick, hard, level is not smooth, a ring is bad in development, juncture of a leaf may be merged, it influences the sacculus to expand the result directly that these dissect the characteristic. Expanding the result may be merged and concerned with intersection of a leaf certainly or not, one of the reasons of one that also not to pass a shaping skill result of ball bag lung artery.
( 2) Chosen the size of the sacculus diameter: The intersection of artery and petal narrow to go on PBPV result to be bad to the intersection of development and getting bad lung, relate to the fact that the sacculus chosen has not reached enough balls a ratio. Should use the sacculus law oversize to recommend at present, namely the ball a ratio is up to 1.4-1.5, the recent good result is up to 69%, the long-term result is up to 77%. So one is narrow to the bad type lung artery of development, especially light case, can still choose the sacculus first and expand the skill, if consider opening the chest operation again invalid.
The lung artery is shunted left in horizontal right of a narrow companion's atrium
It causes the pressure of right ventricle to obviously increase that the serious disease lung artery one is narrow, many companion oval holes are opened, or amalgamate small-scale ASD, thus cause the horizontal right of atrium to shunt left. Such as relying mainly on the fact that the valve type is narrow, should walk the sacculus expand the skill. Can expand with the small sacculus first, expand again with bigger form sacculus or one pair of sacculuses subsequently, but need to watch out for the air, clot through oval hole or ASD, cause thromboembolism of systemic circulation. With continue, send pass ASD to suitable for by person who stops up conduit, should walk and stop up the skill treatment at the same time.
Funnel one of right ventricle is plump that a narrow companion continues the taking place lung artery
A part, severe the intersection of lung and the intersection of artery and petals of narrow patient can funnel portion continue person who take place to be narrow with right ventricle, though lung the intersection of artery and petal, obstruct and relieve, at once, the right room funnel portion pigeonholes difference and still exists with the right ventricle bottom, but right ventricle funnel one is plump can disappear gradually, so is still first-selected therapeutic method through a shaping skill of ball bag lung artery. If the right ventricle flows out one for not continuing the hair plumply, it is difficult to disappear after a shaping skill of ball bag lung artery.
The neonatal lung artery one is narrow
It is usually 2- 4 years old through the lung artery optimum age of a narrow shaping skill of the ball bag, neonate issue appear symptom person to be more narrow for serious the intersection of disease and the intersection of lung and the intersection of artery and petal promptly, accompany the intersection of hypoxemia and disease and acidosis often, need acute disease to deal with. It is the shaping skill indication of the sacculus that the simple lung artery one is narrow, but complication is seen more. If lung artery petal narrow to amalgamate right ventricle getting bad development or companion part narrow funnel have, it is not the sacculus that expands the first-selected indication of the skill, often need to do the body - by-pass surgery of lung.
The sacculus expands skills to employ in the worry in the complicatedness first
1. Fallow's block of four
In most cardiovascular centres, Fallow's block of four of serious disease accompanies the bad one of artery development of lung, regular to adopt by stages performing the operation, employ by-pass surgery first or right ventricle flow out line step petal mend scenes of skill, relieve cyanosis, improve hypoxemia disease, the second issue adopts and radically treats the skill. Have report adopt, expand the skill through the intersection of ball and the intersection of bag and the intersection of lung and the intersection of artery and petals of shaping skill and the intersection of lung and the intersection of artery and the intersection of branch and narrow sacculus, in order to improve hypoxemia disease and promote the artery development of lung, thus substitute the surgical palliative operation. Choose target that the sacculus expands as, have obvious the intersection of hypoxemia and disease, oxygen deficiency break out and the intersection of companion and the intersection of lung and artery getting narrow branch have. The working technique is the same as simple shaping skill of a narrow sacculus of lung artery, the sacculus ratio report of a ring differs, because a ring of Fallow's block of four is all normal, selecting the ball a ratio for use should be missed greatly. PBPV is narrow because of the funnel one to remain as before, the pressure of postoperative right ventricle and lung artery - pressure rank of right ventricle are only reduced badly slightly, or has not obviously changed, but postoperative blood and oxygen saturation lever has rising at various degrees, oxygen deficiency breaks out and improves, the blood flow of lung increases, contribute to the branched development of lung artery. A few the intersection of patient and sacculus take shape, take place while being postoperative reactive right ventricle funnel part narrow and causing oxygen deficiency to break out.
2. The intact lung artery of interventricular septum is locked
The intact lung artery of interventricular septum is locked ahead of worry for infancy rare in weight disease and cyanosis type, die of more hypoxemia diseases, need to employ prostaglandin E to expand the artery conduit and improve hypoxemia disease in early days. In order to guarantee a patient survives, the skill of punching of the feasible radio frequency, then pass through a shaping skill of ball bag lung artery. The method can regard as surgery, radically treat palliative operation before the skill, but some case combine this, treat, can achieve the goal of effecting a radical cure by law and involvement in the future. See and inlay and treat specifically.
3.The right ventricle flows out one and obstructs after the surgery
Adapt to card including the intersection of living beings and petal it replaces to be can't be more postoperative, apply the intersection of Fallow and the intersection of block of four and disease to accompany the intersection of lung and artery lock, not getting complete main artery transfer location and the intersection of perpetuity and the intersection of artery and the intersection of person who be and case to mainly, surgery adopt with kind or different kinds of the intersection of living beings and petal making the intersection of right ventricle and the intersection of lung and artery, bringing petals of pipelining radically treat skill, take place and then narrow while being postoperative, can consider making the sacculus and expanding the skill. Sacculus its expand the intersection of success rate and the intersection of report and one ' 33%- 100%) ,How long its curative effect can keep to still need to further observe, because the method is simple and convenient and has certain results, still surgery replaces the valve or places the treatment means in front of the support in the blood vessel again. Narrow majority meet on getting complete main artery transfer location to dissect, correct, manage the intersection of lung and artery identical port narrow in behind the operation at the the intersection of lung and the intersection of artery and petal, need whether to select the sacculus for use and expand the skill according to the condition decision or not; The intersection of lung and high-pressure infant, companion of ventricular septal defect, infancy competent the intersection of lung and the intersection of artery and ring pitch operation once, while making ventricular septal defect and radically treating the skill, pitch ring roll over except that after narrow at the artery petals when lunging will take place, can also try the sacculus and expand the skill. Patients the above-mentioned appearance right heart depletion symptom or ( Sum) The person who greater thans the aorta pressure 60% of the pressure of right ventricle, because amalgamate deformity in the heart more, often need the surgery to treat.
4.Other complicated cyanosis type worry accompany lung artery one narrow first
Except Fallow's block of four, also can apply by ball to other and complicated by the intersection of bag and the intersection of lung and the intersection of artery and petals of shaping skill worry accompany lung the intersection of artery and petal narrow first, if single ventricle accompany lung artery petal main artery transfer persons of the intersection of companion and ventricular septal defect, the intersection of lung and the intersection of artery and petal and petal to down narrow, etc narrow, complete. Make the blood flow volume of lung increase after a shaping skill of ball bag lung artery, in order to improve hypoxemia disease, thus substitute and make the body of chest - artery by-pass surgery of lung.
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