【Fontan手术后左肺大动静脉畸形的闭合(病例报告)】。

K V Petrosian, V P Podzolkov, G M Dadabaev, A V Sobolev, Kh A Khakimov
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引用次数: 0

摘要

在应用腔隙肺吻合(Glenn手术)和Fontan手术时,经常发生肺动静脉畸形(占所有病例的25%)。这可能直接关系到静脉系统肝段血流动力学的重组,以及随后在此背景下肝功能的变化,以及肝酶-抗血管生成因子不进入肺循环,以及“非脉动”肺血流的形成。在这种情况下,血管内治疗创伤最小,并显示出高效率,然而,这些干预措施的长期结果调查很少,研究的患者群体极小。目前,栓塞治疗是动静脉畸形患者的主要治疗选择之一,特别是当血管异常位于肺实质深处时。所提出的方法是微创的,相对容易执行,并产生良好的效果。
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[Closure of a large arteriovenous malformation of the left lung in a patient after Fontan procedure (case report)].

The development of arteriovenous pulmonary malformations quite often (up to 25% of all cases) occurs when applying a cavopulmonary anastomosis (Glenn procedure) and performing the Fontan procedure. This can be directly related to both the restructuring of hemodynamics in the hepatic segment of the venous system, with subsequent changes in the liver function against this background and the non-entry of hepatic enzymes - antiangiogenic factors into the pulmonary circulation, and the formation of a 'non-pulsating' pulmonary blood flow. Endovascular treatment in this case is minimally traumatic and demonstrates high immediate efficiency, however, the long-term outcomes of these interventions have been poorly investigated, with the studied groups of patients being extremely small. Today, embolization therapy is one of the main treatment options in patients with an arteriovenous malformation, especially when a vascular anomaly is located deep in the lung parenchyma. The proposed method is minimally invasive, relatively easy to perform and yields good results.

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