腔内隔绝术治疗成人巨大动脉导管未闭

Endovascular graft exclusion of large patent ductus arteriosus in adults

目的总结12例腔内隔绝术治疗成人巨大动脉导管未闭的经验，评估其疗效。方法回顾性分析2009年4月至2012年10月上海远大心胸医院12例成人巨大动脉导管未闭行腔内隔绝术的临床资料，其中男性5例，女性7例，年龄18-56（34．2±13．5）岁。动脉导管肺动脉侧直径（19．2±4．5）mm，肺动脉收缩压（92．4±5．8）mmHg，使用支架直径（34．8±3．0）mm。术后随访（17．8±10．5）个月。结果术后造影显示11例动脉导管完全封闭，1例术中预留5mm残余分流。随访显示11例动脉导管完全封闭，肺动脉压明显下降，1例残余分流为双向分流。术后症状明显缓解。结论腔内隔绝术治疗成人巨大动脉导管未闭近期疗效满意，是一种安全有效的方法。

Objective To summarize the experience of 12 cases with large patent ductus arteriosus （PDA） treated endovascular graft exclusion by using covered stent, and to evaluate the effects of this operation. Methods From April 2009 to Oct 2012, 12 patients underwent stent graft implantation, of whom 5 were male and 7 were fe- male. The average age was （34.2±13.5）. Average diameter of PDA was （19.2±4.5）mm and average pulmonary artery systolic pressure was （92.4±5.8）mm Hg. Average diameter of stent grafts was （34.8±3.0）mm. All the pa- tients were followed for （17.8±10.5）months. Results Angiography showed that complete occlusion of PDA was achieved in 11 cases immediately after stent-graft implantation, and obligated residual leak in 1 case. Pulmonary artery pressure decreased obviously in 11 cases. Bidirectional shunt at level of aorta was found in 1 patient. Symp- toms disappeared in all the patients during the follow-up period. Conclusion Early outcome of endovascular graft exclusion of PDA with covered stent is encouraging. This procedure is safe and effective.