The congenital heart attack is the period and the most familiar cardiovascular disease in child and check a rate as 0.7% in the new born.For the congenital heart attack, the surgical operation is a tradition treatment method, have already very had abundant of experience and good treatment effect, and still is continuously developping.But the surgical operation need to open chest(surgical operation in or have heart lung outside the body to turn to flow), hurt greatly.In addition, the artery pipe shut to have with room after separate the defection and damage surgery the Shu certain of then rate, among them a part demand again surgical operation treatment.Since 1964 Dotter etc. founded an afferent disease to get involved treatment, along with experiment, clinical with get involved material of research progress, pass son Medicine tiny create of get involved a treatment method act for surgical operation treatment of category and amount quickly increase, such as more than ten year agos mainly cure lung artery a petal narrow with a part of artery pipes shut, have already can cure various type and dissimilarity diameter in recent years of the artery pipe shut, greatly part of after hair bore type of the room separate defection and damage, muscle department room partition defection and damage, coronary artery to leak, the aorta petal be narrow, two the sharp petals be narrow, three the sharp petals be narrow, the aorta Suo be narrow, lung artery the branch be narrow, the action vein abnormal and the action vein Lou etc..Make some first secret concern of the traditional treatment method took place the change of root.
A, artery pipe’s having never shut(PDA) to seal have already blocked up a Shu research for more than 30 years and worked hard in the past the pipe sent into foam plastics a plug to stop artery pipe and shut.Transport a sheath tube to push to send a plug because of needing to be more and thickly, to the artery hurt more and greatly, past can used for the diameter bigger artery pipe and shut and adapt scope smaller, have already tend currently in eliminate.In 1979 hereafter successively tried out the two-sided umbrella, the button up type of Sideris Niu of the Rashkind to repair slice and spring coil turn to stop to shut to match and don’t shut artery pipe.But stop to the infant and the small PDA more difficult, and the Shu destroy a remaining reposition of redundant personnel rate behind higher, and can cause dissolve of severity blood, and the sideris repair a slice of easy occurrence to move and fold etc. complications, can not at clinical up expansion.Release to whet a mushroom umbrella to seal to block up a machine for the very first time in 1997, its equip is weave by the super and flexible Nie titanium metal alloy silk but become, sew the 3 or 4 F Di Lun slice in the mushroom umbrella the support of the type, can pass the F5 ～ F7 sheath tube and send through the vein system into seal to block up a machine.With seal to block up material to compare before, with the surgical operation of its special design, good function and simplification, basically came to a pure artery pipe and shut a target of need the surgical operation treatment no longer.The surgical operation success rate almost can reach to 100%.
Two, room’s separating defection and damage(ASD) be one of the most familiar congenital heart attacks, after hair bore’s type’s defection and damage is it the most familiar type.Since go toward surgical operation is that it be the only treatment method, along with the improvement of the apparatus and the transmission system, after hair bore type the get involved of ASD cure to also gradually head for mature.Once equip with a pair of umbrellas forms, the clam form clip type shut to match a machine and the Niu button up type of kite form repaired a slice of close ASD and the CardioSEAL new generation to seal to block up a machine.(2 years old to≤ or the child obsolescent of the weight ≤ 8 kgs, was applicable to the 20 mms following defection and damage)Exist a following problem:(1)Mostly need bigger transport a sheath tube, isn’t suitable for at child’s sufferer;(2)The operation is complicated and seal to block up a machine once releasing a sheath tube if be unsuited to proper namely hard take back, the safety is worse;(3)Seal to block up incompletion, the Shu seals to block up a machine to easily move behind and often exist more and greatly cripple remaining reposition of redundant personnel;(4)Parts of metals arms can take place to break. 1997 seals to block up a machine with the Nie titanium metal alloy of one Amplatzer double dish form behind.That blocks up a machine operation simple, the effect credibility, adaption be wide, safety Gao, have the room with 5 mms to the central type defection and damage, indentation edge to separate organization, edge to leave coronal Dou and the lung vein 5 mms above, the room separate defection and damage diameter small can consider at the 38 mm application.In addition, this kind of method is small to hurt of vein and the ASD which is suitable for a 2-4-year-old kid seals.But, compare the ASD diameter big 10-14 mms because of sealing to block up a machine side path, so request room to separate to have equal capacity to seal by accept to block up a machine, this to baby’s kid, child is importance.Also probably cause the blood bolt.(the Shu is behind all the normal regulations give heparin for a week and take orally department wood)In recent years, and then release the room of new spiral type to separate defection and damage to seal to block up a machine, metals silk in order to seal a support of block up the machine, on the metals silk sew up a PTFE(polytetrrafluoroethylene) film, push to send in the pipe present to stretch a form, while pushing to send to go into left atrium present a dish form, return to pull to the room to separate place, such as the super voice show position good, continue to release a repair of right atrium slice, the flexibility that the slice passes an oneself of two repair of sideses, clip two sideses which separate in the room.Its advantage is a metals composition less.
Three, the room partition’s defection and damage(VSD) get involved sex treatment always is that has a controversy.The left room chamber is placed in high pressure appearance, transform along with the ventricles constringency room partition, make to seal to block up device to move or hurt structure creation inside the heart, so the room partition defection and damage stop a machine setting compare the room separate defection and damage difficulty, setting empress of problem far compare room to separate defection and damage have another.The muscle department VSD safety is opposite and higher, but outbreak little, it clinical meaning not equal to film department VSD importance, but film department VSD because of close to the aorta petal, the building room petal and conduction tie etc. importance dissect structure, defection and damage surroundings have no enough edge, so as to it’s in the way of pipe carry on a safe to block up to want compare muscle department the VSD be more difficult.Successively applied the Rashkind two-sided umbrella to seal to block up the machine, Cadioseal two-sided umbrella to seal to block up a machine, the button up type of Sideris Niu to repair slice and Amplatzer to seal to block up VSD and parts of film department rooms of the machine close muscle department to lack to once acquire success.But the room partition film department’s defection and damage get involved a treatment to is still to pay attention to in recent years of a little bit hot, sealing to block up a develop of machine may be a finally problem-solving key.
Four, ball bag the building separate to build a people the Shu treatment completeness aorta to turn with the head carry to take to have pipe of extend the ball bag Be inserted to reach right building to the left building by vein, build a shadow Chong Ying a head the ball bag for carry with the dilution, then fast take out the pipe is from the left building pull to the right atrium, result in the room separate defection and damage, this Shu is called a ball bag building to separate to build a people Shu(BAS).Can make after the Shu infant the completeness aorta turn an etc. paroxysm artery blood oxygen saturation a degree ascension and the sour poisoned and low oxygen blood disease can rectify and act for surgery to open chest enforcement room to separate to cut open Shu thus.That method is simple, valid and safe.Should get involved the success of sex pipe Shu, founded to get involved sex pipe Shu to cure a congenital heart attack first river.The BAS makes the completeness aorta turn 1 year old internal troubles son death rate to descend 60% or so.
Five, through the ball bag valve and blood vessel narrow extend to take shape Shu Be taken shape Shu to include by ball bag blood vessel:Being taken shape Shu(PBPV) by the ball bag lung artery petal is taken shape Shu by ball bag two sharp petals, Be taken shape Shu by the ball bag aorta petal, the aorta Suo is narrow, lung artery the branch be narrow and the chamber vein be narrow and the blood vessel fit together to narrowly take shape Shu.Among them PBPV effect had better, for the typical model lung artery petal narrow, forward with visit effect good, have already can act for surgery to open chest surgical operation, long-term curative effect satisfaction.Congenital two sharp petals’ being narrows isn’t a ball bag to extend Shu of good orientation certificate.
Six, through the skin valve place into the Shu applied the cow neck vein petal be an artificial valve, the biggest diameter can reach to a 18 mms and is fixed it after support, the artificial piping which sends to an of the right ventricles and the lung artery from pipe, Shu build a shadow have no anti- flow, have no complications in the near future, physical strength activity ability improvement.Have method joy a surname four allied advertise for to merge a heavy degree lung artery a petal anti- flow of suffer from son to accept a this kind method treatment to achieve success. First the secret concern gets involved a treatment operation simple, pain and sufferings be small, success rate Gao, safety.Can reach to cure of or reduce disease effect for somely first secret concern, some case adoptions get involved to combine together treatment complications with surgical operation first secret concern, consumedly extended surgical operation adaption and success rate, so is worthy of strongly expand of treatment technique.But get involved check and cure with other paroxysms similar, all have creation complications of possibility, such as blood vessel hurt, heart wall bore hole, seal to block up a machine to shed off, the blood bolt to fill, impatient dissolve blood etc..Should have full preparation to this. Be close to more than 10 in the last yearses, our country the congenital heart attack get involved sex pipe Shu to develop more and quickly, some get involved a sex pipe wood regardless on the amount and category upper part close international advanced level, domestic minority of cardiovascular center lately technical application almost with abroad synchronous.Because our country everyplace of economy development unbalance, for large region but speech, expensively get involved sex material expenses still for expand the obstacle of this technique
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