应用Amplatzer封堵器经导管治疗动脉导管未闭开胸术后再通的疗效评价

Transcatheter closure of residual patent ductus arteriosus shunting after surgical ligation using the Amplatzer occluder

目的 :应用 Am platzer封堵器经导管治疗动脉导管未闭 (PDA)开胸术后再通并对其疗效进行评价。方法 :全组10例 ,年龄 11± 8(4～ 32 )岁。PDA最窄处直径为 4± 4(2～ 13) mm。封堵后 10 m in行侧位降主动脉造影 ,术后 1d及 1月行超声心动图检查 ,观察有无残余分流及 PDA再通。结果 :9例 PDA采用 Am platzer PDA封堵器治疗 ,1例采用 Amplatzer房间隔缺损封堵器治疗。术后 10 m in降主动脉造影显示 ,3例存在微量～少量残余分流 ,7例封堵完全无残余分流。术后 2 4h、术后 1月超声心动图均未见残余分流及再通。结论 :应用 Amplatzer封堵器治疗动脉导管未闭外科术后再通是一种安全有效的介入方法。

AIM: To evaluate the treatment efficiency of transcatheter closure of residual patent ductus arteriosus (PDA) shunting after surgical ligation using the Amplatzer occluder device. METHODS: 10 patients with PDA underwent attempted transcatheter closure of a residual PDA using the Amplatzer occluder device at a median age of 11±8 years (range 4 to 32). The mean diameter of residual PDA at its narrowest segment was 4±4 mm (range 2 to 13). The lateral descending aortographies were performed to evaluate the immediate results 10 minutes after the procedure. Echocardiographies were performed 1 day, 1 month after the closure to find whether there was residual shunt and recanalization. RESULTS: 9 patients with residual PDA shunting underwent attempted transcatheter closure of a residual PDA with the Amplatzer ductal occluder, 1 case with the Amplatzer atrial septal defect occluder device. Angiography showed that 7 patients had complete immediate closure, 3 had a trace to small shunt 10 minutes after the procedures. Within 24 h, color Doppler revealed complete closure in all patients. No residual shunt and PDA recanlization after the complete closure were found in 1 month following up. CONCLUSION: Transcatheter closure of residual PDA shunting using the Amplatzer occluder device is a safe and effective interventional therapy. It had a high successful rate of technique and satisfied immediate and short term results.