经导管介入治疗动脉导管未闭120例临床分析

Clinical Analysis on Transcatheter Closure of Patent Ductus Arteriosus:a Report of 120 Cases

目的评价经导管介入治疗动脉导管未闭(PDA)的有效性及安全性。方法全组120例患者,年龄(23.5±16.0)岁。降主动脉造影确定动脉导管的形态及最窄径,选择合适的封堵器。术前及术后1,3及6个月行超声心动图检查。结果 PDA最窄径1.5～14.0mm,平均(5.7±3.0)mm。封堵成功率99%。术后即刻残余分流38%,1个月时无残余分流。9例重度肺动脉高压患者术前肺动脉收缩压83～155mmHg(1mmHg=0.133kPa),平均(108.6±21.6)mmHg,术后1个月时降至36～92mmHg,平均(54.1±16.6)mmHg(P<0.01)。无严重并发症发生。结论在严格掌握适应证的前提下,经导管介入治疗PDA安全有效。

Objective To evaluate the efficacy and safety of transcatheter closure of patent ductus arteriosus（PDA）.Methods One hundred and twenty patients with PDA were treated by transcstheter closure with domestic duct occluder.The mean age was（23.5±16.0） years.Lateral descending aortographies were performed for determining the minimal diameter of the ductus.Echocardiography was given before the operation and during follow-up at 1,3,and 6 months after closure.Results The minimal diameter of the ductus was 1.5-14.0（5.7±3.0）mm by aortography.Complete aortography closure was seen in 62% at 15 min after the procedure,but complete echocardiography closure was 100% at one month after the procedure.The systolic pulmonary pressure decreased from 83-155（108.6±21.6）mm Hg to 36-92（54.1±16.6）mm Hg（P0.01） during the one month follow-up in 9 cases with severe pulmonary hypertension,No severe complications were seen during follow up.Conclusion Transcatheter closure of PDA is a safe and effective therapy under strict indication selection.