国产Amplatzer封堵器治疗动脉导管未闭62例临床分析

Clinical Analysis on Transcatheter Closure of PDA with Domestic Amplatzer Ductus Occluder: A Report of 62 Cases

目的 探讨应用国产Amplatzer封堵器（ADO）介入封堵治疗动脉导管未闭（PDA）的有效性和安全性,评价其近期和中期疗效.方法 全组共62例,年龄3～42岁,平均（18±8）岁.对所有患者封堵治疗的临床资料进行回顾分析,对成功封堵的61例患者分别于术前和术后1～3d、1个月及3个月行经胸超声心动图（TTE）评价其近期和中期疗效.结果 封堵成功率98.4%,术后即刻残余分流率8.2%;封堵器脱落1例,最终行急诊开胸术,术后恢复良好;TTE示成功封堵患者的肺动脉压力、肺动脉内径、左房及左室内径术前和术后比较差异有统计学意义.结论 应用国产ADO介入封堵治疗PDA可以明显改善患者心血管形态和功能,是一种新的安全、有效的治疗手段.

Objective To evaluate the efficacy and safety of transcatheter Closure of Patent Ductus Arteriosus （PDA） with domestic amplatzer ductus occluder and to assess the short-term and middle-term effects. Methods 62 patients with PDA were treated by transcatheter Closure with domestic amplatzer ductus occluder. The mean age of the patients was 18 ± 8 years（ranged from 3 to 42 years old）. The clinical information of all patients was reviewed retrospectively. Transthoracic Echocardiography（TTE） examination were done before operation and followed-up at the lst-3rd day, the first month, and the third month after the procedure. It was done to compare the pressure and size of pulmonary vascularity and the size of left atrium and left ventricle by TIE. Results The success rate of implantation was 98.4 %. Aortography and TIE showed that the immediate residual shunt rate after the procedure was 8.2 %. Dislocation of the device was found in one patient. Finally, patients were treated by thoracotomy successfully. TIE showed that the pressure and size of pulmonary vascularity and the size of left a- trium and left ventricle were significantly improved. Conclusions Transcatheter Closure of PDA using domestic amplatzer ductus occluder is an efficient and safe therapy methods. The operation can improve the cardiovascular configuration and function in PDA patients. It can be a new, safe, and efficient therapy method for PDA.