TRANSCATHETER CLOSURE OF PATENT DUCTUS ARTERIOSUS

Objective To explore the efficacy of transcatheter closure of patent ductus arteriosus (PDA) with detachable coil and Amplatzer duct occluder (ADO). Methods Transcatheter colsure of PDA was performed in 160 cases, aged 4.56±2.67 years, of whom 3 had residual shunt after surgical ligation, 2 had pulmomary stenosis (PS), 1 had coarctation of aorta (COA), 1 had right aortic arch, and 2 had atrial septal defect (ASD). Results Detachable coils (Duct Occlude pfm or Cook Inc) were successfully used in 51 patients with a smallest PDA diameter of 1.86±0.78mm. Amplatzer duct occluders were also successfully performed in other 109 with a moderate to large PDA diameter of 3.89±1.32mm, of whom 3 with PS or COA were performed balloon dilation firstly, and 2 with ASD were performed PDA occlusion firstly; 1 month to 4.8 years follow-up coil or Amplatzer device closure of PDA showed that neither residual shunt nor any complication. Conclusion It is suggested that the detachable coil and Amplatzer duct occluder are simple and safe for the catheter closure from small to large sized PDA.

扩张压力对兔颈外静脉移植物再狭窄的影响

目的 研究不同扩张压力对兔颈外静脉内皮完整性及颈外静脉桥再狭窄的影响。方法 1 8只NZW兔 ,随机分为A、B、C组。每组兔颈外静脉分别以 50、1 0 0和 2 0 0mmHg(1mmHg=0 .1 33kPa)扩张 ,静脉内银染铺片法和扫描电镜进行内皮完整性评分。扩张后行颈外静脉颈总动脉移植 ,2 8d后测定静脉桥管腔面积和内膜厚度。结果 A组内皮完整性评分 (1 .42 )显著低于B组 (2 .67,P <0 .0 1 )和C组 (3 .83 ,P <0 .0 1 )。A组的静脉桥的管腔面积 (1 1 .3± 2 .0 )mm2 显著大于B组 [(6 .0± 1 .7)mm2 ,P =0 .0 0 1 ]和C组 [(4.5± 1 .2 )mm2 ,P <0 .0 0 1 ] ;A组的静脉桥的内膜厚度 (36 .2± 3 .4) μm显著小于B组 [(52 .3± 7.7) μm ,P =0 .0 0 1 ]和C组 [(53 .1± 5 .8) μm ,P <0 .0 0 1 ]。结论 50mmHg的扩张压力引起的兔颈外静脉桥再狭窄的程度明显轻于 1 0 0mmHg和2 0 0mmHg。