日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
〒162-0801東京都新宿区山吹町358-5アカデミーセンター Japanese Society of Pediatric Cardiology and Cardiac Surgery Academy Center, 358-5 Yamabuki-cho, Shinju-ku, Tokyo 162-0801, Japan
Pediatric Cardiology and Cardiac Surgery 36(2): 143-149 (2020)
doi:10.9794/jspccs.36.143

症例報告Case Report

総肺静脈還流異常を合併した垂直静脈狭窄に対するステント留置中のバルーンエントラップメントEntrapment of a Balloon Catheter during Stent Implantation for Vertical Venous Stenosis in Two Neonates with Single Ventricle and Total Anomalous Pulmonary Venous Connection

1独立行政法人地域医療機能推進機構(JCHO)九州病院小児科Department of Pediatrics, Japan Community Healthcare Organization, Kyushu Hospital ◇ Fukuoka, Japan

2独立行政法人地域医療機能推進機構(JCHO)九州病院心臓血管外科Department of Cardiovascular Surgery, Japan Community Healthcare Organization, Kyushu Hospital ◇ Fukuoka, Japan

受付日:2018年11月13日Received: November 13, 2018
受理日:2019年11月18日Accepted: November 18, 2019
発行日:2020年6月1日Published: June 1, 2020
HTMLPDFEPUB3

近年,単心室・総肺静脈還流異常症(TAPVR)の垂直静脈狭窄に対して,新生児早期の手術を回避すべく姑息的ステント留置が行われている.垂直静脈ステント留置に伴うバルーンエントラップメント2例を経験した.【症例1】在胎40週5日,出生体重3,552 g.単心室,肺動脈狭窄,上心臓型TAPVRの男児.左上大静脈へ還流する垂直静脈狭窄のため出生当日肺うっ血を認め,左内頚静脈よりステント(Express SD® 6 mm)を留置した.ステントにウエストが残存した状態でバルーン回収を試みたが抜去困難となった.【症例2】在胎39週4日,出生体重2,882 g.左心低形成症候群,上心臓型TAPVRの女児.生後1日目,右上大静脈へ還流する垂直静脈の狭窄に右内頚静脈よりステント(Express SD® 8 mm)を留置した.ステントのウエストが残存した状態でバルーン回収を試みたが難渋した.いずれの症例もシースやカテーテルの操作で抜去することができた.垂直静脈狭窄へのステント留置の際は,バルーンエントラップメントを憂慮すべき合併症として認識する必要がある.

To avoid surgical interventions in the management of neonates with single ventricle and total anomalous pulmonary venous return, stenting in the narrowing vertical vein can be performed. We report two cases of balloon entrapment during stenting in such procedures. (Case 1) A 3.5-kg boy born at 40 weeks’ gestation was diagnosed with single ventricle, pulmonary stenosis, and supracardiac total anomalous pulmonary venous return. He developed pulmonary congestion, visible on chest X-ray, due to the narrowing vertical vein draining into the left superior caval vein. Soon after birth, we performed stenting (using Express SD® 6 mm) in the vertical vein with a left jugular vein approach. However, the balloon became entrapped in the stent with a waist after deflation. (Case 2) A 2.8-kg girl born at 39 weeks’ gestation was diagnosed with hypoplastic left heart syndrome and supracardiac total anomalous pulmonary venous return. We performed stenting (using Express SD® 8 mm) in the vertical vein on the day after birth, approaching from the right jugular vein. However, the balloon was entrapped in the stent with a waist and we had difficulty withdrawing the balloon catheter. In both cases, the balloon catheters were able to be withdrawn by manipulation of the sheath and catheter. Balloon entrapment should be acknowledged as a possible serious complication of stenting in the non-compliant vertical vein in neonates with total anomalous pulmonary venous return.

Key words: total anomalous pulmonary venous return; vertical vein; pulmonary venous obstruction; stent implantation; complication; balloon entrapment

This page was created on 2020-06-02T11:32:27.97+09:00
This page was last modified on 2020-06-18T11:01:37.000+09:00


このサイトは(株)国際文献社によって運用されています。