奇美醫院創新手術成功治療「開放性動脈導管」 為先天性心臟病新生兒帶來曙光
2023-10-11 記者 蘇旋/報導
成功案例小安(右二)因開放性動脈導管合併左心室輕度擴大，心導管介入關閉器手術後恢復良好，一家三口幸福的與奇美醫院兒科部主治醫師陳俊宇共同合影
先天性心臟病中的「開放性動脈導管」是一種不常見但須引起重視的疾病，約千分之一的新生兒會出現此問題，占到先天性心臟病的5至10%。雖然大部分的新生兒其動脈導管會隨著年齡增長而自然縮小，但若導管無法正常關閉，可能會出現一系列的健康問題。這會讓大量的血液流向肺部，導致呼吸問題、左心室擴大，並可能伴隨餵食困難、生長發育遲緩等症狀。然而，有了現代醫療技術的幫助，奇美醫院所採用的心導管介入關閉器手術，能成功地封堵動脈導管，而且過程中無需開刀。這種先進的治療方式大大減少了病患的手術風險和恢復時間。
成功案例小安的媽媽(右)於記者會上分享小安當時的就醫經歷
『現年5歲的小安(化名)，最近兩年一直有心雜音，直到最近一次的發燒感染至奇美醫院兒科部主治醫師陳俊宇門診就醫，陳醫師聽診後發現心雜音非常明顯，於是建議做心臟超音波檢查。經過檢查後竟然發現小安有一條2.8mm的「開放性動脈導管併左心室輕度擴大」，於是建議小安接受「心導管介入關閉器」手術，將開放性動脈導管封堵。手術過程順利，採用局部麻醉，總時間含準備僅用了2個小時，當天晚上就可下床走路，由於傷口非常微小(只有大腿內側的兩個針孔)，也沒有併發症。小安住院三天後就出院，門診回診追蹤狀況穩定。』
奇美醫療財團法人奇美醫院兒科部主治醫師陳俊宇表示，幼童心雜音未注意，先天性心臟病來報到！奇美醫院利用心導管介入關閉器手術，成功封堵免敞開心胸！
奇美醫療財團法人奇美醫院兒科部主治醫師陳俊宇說明，臨床治療會先以藥物治療或定期追蹤監測心臟狀況為主，若治療效果不彰或有相關禁忌症時，則可考慮採用心導管介入關閉器手術或開胸式開放性動脈導管結紮手術(開心手術)治療。但由於開胸式手術需打開胸腔、肺葉、麻醉、出血等風險，對於肺及神經等有較大的破壞性，恐有氣管肺發育不良、神經受損、傷口面積大、術後疼痛且會留下疤痕等缺點。由於目前醫療技術發展很快，許多先天性心臟病早已可以使用心導管技術取代開心手術，不僅疤痕較小，且復原時間快，也降低開心手術潛藏的風險及併發症。奇美醫院自2022年引進心導管介入關閉器手術迄今，已完成6例手術，包含心房中膈缺損關閉術、開放性動脈導管關閉術，目前追蹤恢復良好。
開放性動脈導管致幼童餵食困難、生長發育遲緩等，嚴重恐致心衰竭
陳俊宇醫師提醒，若是您的孩子有心雜音、暈厥、呼吸喘、有心臟病史、家族有猝死病史等等，建議安排詳細檢查，如心電圖及心臟超音波檢查。若有發現心房中膈缺損(ASD)或心室中膈缺損(VSD)或開放性動脈導管(PDA)情況，可能需要實行封堵術將心臟問題解決，
成功案例小安於記者會上表示「謝謝陳醫師幫我手術，讓我變健康，您是我的偶像，我也祝福您平平安安」
以避免日後逐漸出現問題(如：肺動脈高壓、心室肥厚、心臟衰竭甚至是猝死)，錯失手術治療先機。
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