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|本期目录/Table of Contents|

三种介入方法治疗动脉导管未闭的疗效评价(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2000年第6期
页码:
452-454
栏目:
论著
出版日期:
2000-12-01

文章信息/Info

Title:
Transcatheter closure of patent ductus arterious usng porstmann technique,occluding coils and amplatzer duct occluder
作者:
张玉顺;  贾国良;  刘建平;  何　争
第四军医大学西京医院心血管内科, 陕西西安710032
Author(s):
ZHANG Yu-shun;  JIA Guo-liang;  LIU Jian-ping;  HE Zheng
Cardiology Department of Xijing Hospital, Fourth Military Medical University, Xi′an Shaanxi 710032, China
关键词:
动脉导管未闭;  经导管封堵术
Keywords:
ductus arteriosus patent;  transcatheter closure
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 评价 Porstmann法、弹簧栓子法和 Amplatzer封堵器对动脉导管培养闭的治疗效果。方法 3种方法共治疗动脉导管未闭 (PDA) 5 0例 ,其中 Porstm ann法 6例 ,弹簧栓子法 10例 ,Amplatzer封堵器 34例。所有患者在 PDA封堵后 10 m in重复主动脉造影观察有无残余分流 ;术后 2 4h、1月、6月和 12月行超声心电图检查 ,观察 PDA有无再通及残余分流。结果 全组 5 0例 ,成功 49例。Porstm ann法有 1例由于鞘管不通过股动脉而失败。术后 10 min主动脉造影术 ,Amplatzer封堵器 4例有微 -少量残余分流。术术 2 4h超声心电图均无残余分流。随访 1～ 12个月 ,均未发现有残余分流和 PDA再通。结论 经导管治疗 PDA是有效的非手术方法。Porstmann法已较少采用 ;直径 <3 m m的PDA首选弹簧栓子法 ;3～ 10 m m的 PDA采用 Am platzer封堵器治疗 ;直径 >10 m m者则应考虑手术治疗。
Abstract:
AIM To evaluate the efficiency of transcatheter closure of patent ductus arteriosus(PDA) using Porstmann technique,occluding coils and Amplatzer duct occluder (ADO) device. METHODS Fifty patients underwent attempted transcatheter closure of a PDA using Porstmann technique,occluding coils and ADO. Among them,6 cases were treated by Porstmann technique;10 cases were treated by occluding coils,and 35 cases were treated by ADO. The lateral descending aortographies were performed to evaluate the immediate result 10 min after the procedure. Echocardiographies were performed in 1 d, 1 mo, 6 mo and 12 mo after the closu re to find whether there was residual shunt and recanalization. RESULTS Forty-nine of 50 patients had successful device placemant. One patient in Porstmann technique group was unsuccessful because the sheath could not pass femoral artery. There were no complicat ions in three groups. Angiography showed that 40 patients had complete closure, 4 patients in ADO had a trace to small shunt in 10 min after the procedures. With in 24 h, color Doppler revealed complete closure in all successful patients. No residual shunt and PDA recanalization after complete closure were found in 1～ 12 mo following up. CONCLUSION Transcatheter closure of PDA is an effective non surgical method for treatment of PDA. Porstmann technique is seldom used now days. Occluding coils should be the method of choice to close the PDA with diameter < 3 mm. ADO device should be used for treatment of the PDA with a diameter ranging from 3 to 10 min; for PDA with a diameter >10 mm. surgical closure should be selected first.

参考文献/References

[1] Porstmann W ,Wierny L ,Warnke H. Closure of the persistent ductus arterious without thoracotomy[J]. Ger Med Mon, 1967,12: 259.

[2] Moore JW , George L , Kirkpatrick SE, et al. Percutaneous closure of the small patent ductue arteriosus using occluding spring coils[J]. J Am Coll Cardiol, 1994, 23: 759.

[3] Masura J , Walsh KP, Thanopoulous B, et al. Catheter closure of moderate-to large-sized patent ductus arteriosus using the new Amplatzer Duct occluder: immediate and shortterm results [J]. J Am Coll Cardiol, 1988, 31: 878.

[4] Krichenki A, Benson LN, Burrows P, et al. Angiographic classification of the isolated, persistently patent ductus and implantations for percutaneous catheter occlusion [J]. Am J Cardiol, 1989, 63: 877.

[5] 钱晋卿, 华仰德, 杨思源. 非开胸法关闭动脉导管350例的经验的体会[J ]. 中国介入心脏病学杂志, 1998, 2: 49.

[6] Cambier PA , Kirby WC, Wortham DC, et al. Percutaneous closure of the small (< 2. 5 mm) patent ductus arteriosus using coil embolizatin[J]. Am J Cardiol, 1992, 69: 815.

[7] Lioyd TR, Beekman II I RH,Moo re JW , et al. The PDA coil registry: report of the first 535 procedures [abstract] [J]. Circulation, 1995, 92 ( suppl 1) : 1.

[8] Hijazi ZM , Geggel RL. Results of anterograde transcatheter closure of patent ductus arteriosus using single or multiple Gianturco coils[J]. Am J Cardiol, 1994, 74: 925.

[9] Sharafuddin MJA , Gu XP, T tus JL, et al. Transvenous closure of secundum atrial septal defects: preliminary result with a new self-expanding nitinol proshesis in a swine model [J].Circulation, 1997, 95: 2162.

备注/Memo

备注/Memo:
收稿日期：2000-01-31.
更新日期/Last Update: 2000-12-01