经导管堵塞动脉导管未闭术的疗效及影响因素分析

Transcatheter closure of patent ductus arteriosus using detachable coil and Amplatzer duct occluder

为探讨经导管堵塞动脉导管未闭(PDA)术的效果,我们经导管堵塞PDA患儿117例,年龄4.52岁±2.86岁。其中外科手术后再通3例,2例伴肺动脉瓣狭窄(PS),1例伴主动脉缩窄(COA),1例伴右位主动脉弓。结果:42例应用可回收弹簧圈(pfm和Cook Inc),其PDA最窄处直径(1.94±0.85)mm,堵塞均获成功;合并PS或COA者,先作球囊扩张,再行堵塞术。另75例应用Amplatzer堵塞器也均一次堵塞成功,PDA最窄处直径(3.83±1.25)mm。所有病例随访1月～4.5年,均无残余分流及任何并发症。结论:可控弹簧圈主要应用于直径小于2.5mm PDA,而直径大于或等于2.5mm PDA则选用Am-platzer堵塞器。

To explore the effect of transcatheter closure of patent ductus arteriosus (PDA) by using detachable coil and Amplatzer duct occluder, transcatheter closure of PDA were performed in 117 cases at an average age of 4. 52±2. 86 years. Among them, 3 cases were with residual shunt after surgical ligation, 2 cases with pulmonary stenosis (PS), 1 case with coarctation of aorta (COA) and 1 case with right aortic arch. The results showed that detachable coil were successfully used in 42 children with a smallest diameter of PDA (1. 94±0. 85rnm). The balloon dilatation was first performed on 3 PDA cases with either PS or COA among 42 cases. Other 75 cases with a moderate to large diameter of PDA (3. 83±1. 25mm) received the treatment of Amplatzer duct occluders smoothly. No residual shunt or any complications in all cases with PDA closure using either coil or Amplatzer device were observed during 1 month-4. 5 years follow-up period. It is concluded that detachable coil and Amplatzer duct occluder are simple, safe and uncommon complications for the catheter closure of PDA from small to large diameter of ductus.