蘑菇伞封堵器封堵动脉导管未闭的即刻及短期疗效观察

Transcatheter Closure of Patent Ductus Arteriosus with Amplatzer Duct Occluder: Immediate and Short-term Outcomes

目的 探讨经皮经股静脉途径蘑菇伞封堵器封堵治疗动脉导管未闭 (PDA)的即刻及短期疗效。 方法 4 6例单纯 PDA患者 (男性 2 0例 ,女性 2 6例 ,年龄 10 .3± 10 .6岁 ,体重 2 4 .1± 14 .7kg,X线主动脉造影测量PDA最窄处的直径 6 .0± 2 .1mm ,长度 7.6± 1.6 mm。采用蘑菇伞动脉导管封堵器经皮经股静脉封堵治疗 PDA,应用 X线造影术观察即刻疗效 ,并以超声心动图观察短期疗效、随访半年。 结果 4 6例患者封堵治疗的成功率为 95 .7% ,其中 1例发生急性溶血予手术取出封堵器 ,1例因选用最大封堵器未能完全封堵 PDA而予收回封堵器。即刻及 6个月内随访未发生封堵器脱落及其他严重并发症 ;术后即刻、30 m in、1天、1个月、6个月分流完全阻断率为 5 6 .8% ,86 .4 % ,88.6 % ,95 .5 %和 97.7%。最终所选择的封堵器尺寸 (D2 )与 X线造影测量的 PDA最小直径 (D1 )之间呈线性相关关系 :D2 =1.6 D1 - 0 .1(r=0 .96 ,SE=1.0 4 )。 结论 蘑菇伞动脉导管封堵器治疗 PDA痛苦少、安全性高、短期疗效好 ,长期疗效尚需多中心大规模临床验证。

Objective\ To evaluate immediate and short\|term results of transcatheter closure of patent ductus arteriosus(PDA) with Amplatzer duct occluder(ADO).\ Methods\ Forty\|six patients with PDA, aged 2～65 years(10 3±10 6 years), weighed 2 7～50 3 kg(24 1±14 7 kg), measured 2 7～12 1 mm(6 0±2 1 mm) of PDA, underwent transcatheter closure using ADO.\ The immediate and short\|term occlusion of shunting was assessed by aortography and echocardiography.\ Results\ Forty\|four patients out of 46(95 7%) had PDA occlusion successfully, except one case acute hemolysis and another case of incomplete closure.\ Within 6 months of follow\|up, there was neither dislodge of ADO nor severe complications found.\ Shunting occlusion occurred immediately, and at 30 minutes, 24 h, one month and six months after the procedure was 56 8%, 86 4%, 88 6%, 95 5% and 97 7%, respectively.\ There was a linear relation between the final selected size of ADO and the narrowest diameter of PDA: D\-2=1 6 D\-1-0 1(r=0 96, SE=1 04).\ Conclusion\ PDA occlusion using ADO is safe and efficacious based on immediate outcomes and results of short\|term follow\|up, and its long\|term results remain further studies in larger patient. \;