超声心动图评价Amplatzer封堵器经导管治疗动脉导管未闭的疗效

The efficiency of transcatheter closure of patent ductus arteriosus using Amplatzer duct occluder: echocardiographic study

目的 用超声心动图评价Amplatzer封堵器治疗动脉导管未闭 (PDA)的疗效。 方法 130例由临床及超声心动图诊断为PDA的患者 ,经右心导管置入Amplatzer封堵器 ,术后 2 4～ 48h、3～ 6个月 (平均 4.5个月 )复查超声心动图 ,观察有无残余分流及心脏大小变化。结果 PDA直径 2～ 10mm ,平均 ( 4 .6± 1.0 )mm。术后 2 4～ 48h ,12 0例 ( 92 %)分流完全消失 ;8例残余微量分流 ;1例残余中量分流 ,17h后发生溶血 ,5 4h后外科急诊行PDA缝合术 ;1例用Amplatzer封堵器封堵并加用弹簧栓子后 ,仍有中量残余分流 ,急诊行外科PDA缝合术。术后 3～ 6个月随访 ,所有患者左心均明显回缩 ,8例残余微量分流的患者残余分流均消失 ;封堵器位置固定 ,无移位及脱落 ;无左肺动脉及降主动脉的梗阻。结论 应用Amplatzer封堵器治疗PDA为一安全有效、损伤较小的方法 ,应选择合适的封堵器 ,减少残余分流的发生。

Objective To evaluate the efficiency of transcatheter closure of patent ductus arteriosus (PDA) using Amplatzer duct occluder(ADO) device.Methods One hundred and thirty patients with PDA underwent transcatheter ADO closure.All patients had echocardiographic follow-up at 24～48 hours,3～6 months after closure in order to observe whether there were any residual shunt and the change of heart size.Results The PDA diameters were 2～10 mm,mean ( 4.6± 1.0)mm.Within 24～48 hours after closure,120 patients(92%) had complete closure,8 patients had trivial residual shunt,2 patients had mederate residual shunt,1 of whom developed hemolysis 17 hours after the procedure,and acute surgical closure was performed in both patients.All patients had complete closure 3～6 months after closure.No obstruction of the desceding aorta or the pulmonary artery branches was detected.Conclusions Transcatheter ADO closure is an effective and safe method for treatment of PDA.