Plug封堵器新方法在细小动脉导管未闭治疗中的应用

Application of Plug occluders in small patent ductus arteriosus with interventional therapy

目的探讨Plug封堵器新方法在细小动脉导管未闭介入治疗中的临床疗效。方法选择细小动脉导管未闭的患者38例,全部常规采取经肺动脉侧释放法,可以建立轨道的患者20例为对照组,如果经肺动脉侧不能建立轨道,则采用冠脉技术,经主动脉侧释放法的患者18例为试验组,于术后造影以及术后3天、1个月、3个月、6个月行超声心动图随访,观察研究两组封堵成功率、并发症和远期疗效。结果两组技术成功率100%,试验组的X线辐射剂量为(140.0±5.4)mGy,手术总时间为(20.0±2.6)min,对照组的X线辐射剂量为(200.0±6.2)mGy,手术总时间为(30.0±3.1)min,术后3天、1个月、3个月、6个月超声心动图随访均无残余分流,封堵器位置好,肺动脉压力正常。结论 Plug封堵器新方法介入治疗细小动脉导管未闭安全可行,试验组的X线辐射剂量及手术总时间均较对照组少,试验组优于对照组。

Objective To study the effect of interventional therapy with the new device of Plug occluders in small patent ductus arteriosus （PDA） （diameter ≤3 mm）. Methods Thirty-eight patients the small PDA were divided into two groups according to the approach of device delivery. In the control group （n=20） the occluders were released from the pulmonary artery and in the coronary approach group （n=18）, the occlulers were released by coronary artery approach technic through the aorta. Follow-up including the postoperative imaging and transthoracic echocardiographic evaluation was made 3 days, one month,three months and six months after the procedure. The success rate, complications and the long term outcome were studied butween the two groups. Results All occluders were delivered successfully. The total X-Ray explosure time of the coronary approach group was （140.0±5.4） mGy and the operation time was （20.0±2.6） minutes. The total X-Ray exprosure time of the control group was （200.0±6.2） mGy and its operation time was （30.0±3.1） minutes.No residual shunt was found in both groups. The possition of the occluders and pressure of the pulmonary artery were normal in both groups during follow up. Conclusion Application of Plug occluders in the small PDA are safe.