蘑菇伞型堵闭器在小儿动脉导管堵闭术中的临床应用

Transcatheter closure of patent ductus arteriosus using a new amplatzer mushroom shaped device in children

目的 评价一种新的小儿动脉导管未闭（ＰＤＡ） 堵闭装置———自动扩张蘑菇伞形（Ａｍｐｌａｔｚｅｒ）堵闭器的临床应用价值。方法 ４９ 例ＰＤＡ 患儿（ 男２１ 例，女２８ 例），平均年龄３－４ 岁（０－３～１２ 岁） ，体重平均１２－４ ｋｇ（４－５ ～２３－４ ｋｇ） ；ＰＤＡ 大小平均为３－５ ｍｍ（２－１～７－１ ｍｍ），均用直径为６ ～１０ ｍｍ 的堵闭器进行堵闭。结果 ４９ 例患儿均一次堵闭成功，术后２４ 小时彩色多普勒超声心动图检查仅２ 例有少量残余分流。平均手术时间为４２－０ 分钟（３３～５０ 分钟），平均Ｘ线透视时间为６－５分钟（５～８ 分钟） 。随诊过程中无一例出现任何并发症。结论 采用蘑菇伞形动脉导管堵闭器堵闭ＰＤＡ是一种疗效好、安全、操作简单、适应症范围广的新方法。

Objective To assess the short term efficacy of anterograde transcatheter closure of patent ductus arteriosus (PDA) using a new self expandable, mushroom shaped duct occluder (ADO) device Methods Forty nine children (21 males, 28 females) with PDA were treated by using the ADO device Their median age was 3 4 years (range 0 3 to 12 years) and median weight was 12 4 kg (range 4 5 to 23 4 kg) The average diameter of the PDA at its narrowest segment was 3 5 mm (range 2 1 to 7 1 mm) The device size was 6 mm to 10 mm Results ALL 49 patients had successful device placement Angiography showed that 21 patients had a trace shunt (foaming through the device with no jet), and 2 patients had mild residual shunt identifided by color Doppler echocardiography 24 hours after the procedure The mean time of the procedure was 42 minutes (from 33 to 50 minutes) The mean exposure time to X ray was 6 5 minutes (from 5 to 8 minutes) Conclusion Anterograde transcatheter closure using the new ADO device is an effective therapy for children with PDA