先心病外科残留病变的介入治疗-英文课件.ppt

先心病外科殘留病變的介入治療 周啟東 醫生 翁德璋 醫生 香港大学葛量洪医院小儿心脏科 Division of Paediatric Cardiology, Grantham Hospital Department of Paediatrics and Adolescent Medicine, The University of Hong Kong The 10th South China International Congress of Cardiology 第十屆中國南方國際心血管病學術會議 Complexity of congenital heart operation varies widely Simple Ducts arteriosus ligation Atrial septal defect closure Ventricular septal defect closure Moderate to Highly complex Shunt operations Repair of coarctation of aorta Tetralogy of Fallot repair Rastelli operation Fontan-like operation Arterial switch Konno operation Ross procedure Norwood operation Residual Lesions after Cardiac Surgery for Congenital Heart Disease Residual shunting Ventricular outflow tract obstruction Residual blood vessel stenosis Residual valvar lesions Ventricular dysfunction Cardiac arrhythmias Treatment of Residual Lesions after Cardiac Surgery Medical therapy Surgical treatment Device implantation for rhythm disturbance Interventional cardiac catheterization (IVC) Residual Structural Lesions Medical therapy Not curative, temporary Surgical treatment Conventional Interventional cardiac catheterization (IVC) Widely accepted for treatment of native lesions e.g. PDA, ASD occlusion, valve and vessel dilatations Applicable also to treat residual structural lesions Residual Ventricular Septal Defect :Transcatheter Occlusion Re-coarctation after Surgical Repair :Balloon Angioplasty and Stenting Re-coarctation after Surgical Repair Re-coarctation after Surgical Repair Re-coarctation after Surgical Repair IVC for Re-coarctation IVC is more simple than surgery Highly Effectiveness 90% Re-coarctation after Surgical Repair Re-coarctation after Surgical Repair Re-coarctation after Surgical Repair Reduce recoarctation by providing support to prevent recoil after balloon dilation Reduce risk of aneurysm formation and aortic rupture Limitations Not suitable for small child Large sheath relative to the vessel Restenosis can sti