应用Am platzer封堵器治疗动脉导管未闭

Transcatheter Closure of Patent Ductus Arteriosus Using the Amplatzer Occluder

目的 评价 Amplatzer封堵器在动脉导管未闭 (PDA)介入治疗中的安全性和疗效。 方法 自 2 0 0 0年9月开始应用 Amplatzer封堵器治疗 30例 PDA患者 ,在术后 2 4小时、1个月、3个月行超声心动图检查 ,观察封堵效果及有无并发症。 结果 PDA最窄处直径为 2 .5～ 12 .0 mm,平均 5 .3mm;1例伴有重度肺动脉高压的粗大 PDA采用 Amplatzer房间隔缺损封堵器治疗 ,余 2 9例用 Am platzer PDA封堵器。2 9例术后 2 4小时、1例 48小时时彩色多普勒超声心动图检查均未见残余分流 ,1例术后早期发生机械性溶血。随访中 ,未出现封堵器移位、残余分流和再通。结论 应用 Amplatzer封堵器治疗 PDA是一种安全有效的非外科手术方法 ,适应证广、技术成功率高、近期疗效满意 。

Objective To assess the safety and efficacy of the Amplatzer occluder in transcatheter closure of patent ductus arteriosus(PDA). Methods Since September 2000, 30 patients with PDA underwent transcatheter closure using the Amplatzer occluder via antegrade venous approach.Follow up evaluations were performed with echocardiogram at 24 hours and 1 and 3 months after implantation of the device. Results The PDA measured from 2.5 to 12.0 mm(mean 5.3 mm) at the narrowest diameter. One huge PDA complicated with severe pulmonary hypertension was closed by the Amplatzer atrial septal device, while the other 29 were by duct occluder.No residual shunt was found in all cases after occlusion for 24 hours(1 patient for 48h) through examination by color doppler echocardiography.Hemolysis occurred in one patient.No residual shunt or device displacement or PDA recanalization was found in the follow up. Conclusion Transcatheter closure of PDA using the Amplatzer occluder is safe and efficacious.It has a wide indication,high success rate of implant and satisfied instant or short term result.The long term effect needs further observation.