带阀门内支架介入治疗疑难动脉导管未闭的临床研究

Clinical study on difficult PDA by transcatheter treatment with WYW

目的 介绍利用带阀门内支架 (WYW )方法介入治疗疑难动脉导管未闭 (PDA)的临床应用经验。方法 40例PDA患者 ,降主动脉造影显示PDA内径 (最狭处 )为 1.4～ 13 .3mm ,平均为 5 .8mm。PDA形态 :漏斗型 7例、管型 15例、乳头型 9例 ,窗型 3例、PDA结扎术后再通 6例 ( 2例为两次结扎术后再通 ,1例为体外循环下缝扎术后再通 )。其中 2 5例 ( 62 .5 % )属疑难PDA范畴。结果 用WYW方法一次堵闭的成功率为 97.5 %( 3 9/3 7例 )。即刻PDA造影显示无残余分流 ;术后第 1天 ,胸部正侧位片检查可见支架固定良好 ;出院前超声心动图检查无残余分流。随访 2～ 85个月 ,无一例再通 ,恢复良好。结论 带阀门内支架的技术及装置可靠、有效 ,简化了手术 ,可堵闭各种类型的PDA ,尤其适用于疑难PDA 。

Objective To introduce the clinical experience of the method of WYW for difficult PDA. Methods Among the 40 patients of PDA (31 females and 9 males) aged 3 to 67 (mean age 26.6 ). The descending aortic angiography showed the diameter of PDA was 1.4～13.3 mm (mean 5.8 mm), and the patterrns being infundibular form (7 cases), tubular form (15 cases), papillary form (9 cases), fenestra form (3 cases ) and reopened after ligation (6 cases). Among these, there were 25 difficult PDA (62.5%). Results 39 case...