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应用Amplatzer封堵器经导管治疗直径≥8mm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:
2001年第3期
页码:
204-205, 208
栏目:
先心病介入治疗
出版日期:
2001-05-01

文章信息/Info

Title:
Transcatheter closure of patent ductus arteriosus with≥8mm diameter using the Amplatzer duct occluder
作者:
张玉顺;  代政学;  贾国良;  曾 筝;  刘建平
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;  Dai Zheng-xue;  Jia Guo-liang;  Zeng Zheng;  Liu Jian-ping
Cardiology Department of Xijing Hospital, Fourth Military Medical University, Xi' an Shaanxi 710032,China
关键词:
动脉导管未闭; 介入治疗
Keywords:
ductus arteriosus;  patent;  interventional therapy
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的 应用Amplatzer封堵器经导管治疗直径≥8 mm的大型动脉导管未闭(PDA)并对其疗效进行评价。方法 全组50例,年龄26.4±23.2(4.0~60.0)岁。PDA最窄处直径为10.2±2.3(8.0~15.0)mm。封堵10 min后行侧位降主动脉造影,术后1 d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 47例PDA采用Amplatzer PDA封堵器治疗,2例采用Amplatzer ASD封堵器治疗,1例PDA伴有阻力性肺动脉高压未行介入治疗。术后10 min降主动脉造影显示,19例存在微~少量残余分流,30例封堵完全无残余分流。术后24 h、术后1月 超声心动图未见残余分流及再通。结论 应用Amplatzer封堵器治疗直径≥8 mm的大型动脉导管未闭是一种安全有效的介入方法。
Abstract:
AIM To evaluate the treatment efficiency of transcatheter closure of patent ductus arteriosus (PDA) diameter≥8 mm using the Amplatzer occluder device.METHODS Fifty patients with PDA underwent attempted transcatheter closure of a PDA using the Amplatzer occluder device at a median age of 26.4±23.2 years (range 4.0 to 60.0). The mean PDA diameter at its narrowest segment was 10.2±2.3 mm (rang 8.0 to 15.0). The lateral descending aortographies were performed to evaluate the immediate results 10 min after the procedure. Echocardiographies were performed 1 day, 1 month after the closure to find whether there was residual shunt and recanalization.RESULTS 47 patients with PDA underwent attempted transcatheter closure of a PDA with the Amplatzer occluder device, 2 cases with the Amplatzer atrial septal defect occluder device. 1 PDA case with resistant pulmonary hypertension could not be treated. Angiography showed that 30 patients had complete immediate closure, 19 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 Anterograde transcatheter closure using the Amplatzer occluder device is a safe and effective interventional therapy for patients with a PDA diameter≥8 mm. It had a high successful rate of technique and satisfied immediate and short term results.

参考文献/References

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[2] Rashkind WJ, Mullins CE, Hellenbrand WEet al. Nonsurgical closure of patent ductus arteriosus: clinical application of the Rashkind PDA occluder system[J].Circulation, 1987,75(3):583-592.

[3] Moore JW, George L, Kirkpatrick SEet al. Percutaneous closure of the small patent ductus arteriosus using occluding spring coils[J].J Am Coll Cardiol, 1994,23(3):759-765.

[4] Rao PS, Sideris EB, Haddad Jet al. Transcatheter occlusion of patent ductus arteriosus with adjustable buttoned device: initial clinical experience[J].Circulation, 1993,88(3):1119-1126.

[5] Krichenki A, Benson LN, Burrows Pet al. Angiographic classification of the isolated, persistently patent ductus and implantations for percutaneous catheter cclusion[J].Am J Cardiol,1989,63(12):877-880.

[6]张玉顺,贾国良,何 争,等.应用Amplatzer封堵器治疗动脉导管未闭的疗效评价[J].中国介入心脏病杂志2000,8(2):78-80.

[7]张玉顺,贾国良,何 争,等.应用COOK可控弹簧栓子封堵动脉导管未闭[J].心脏杂志,2000,12(5):382-384.

[8] Masura J, Walsh KP, Thanopoulous Bet al. Catheter closure of moderate-to large-sized patent ductus arteriosus using the nwe Amplatzer. Duct occluder: immediate and short-term results[J].J Am Coll Cardiol, 1988,31(4):878-882.

备注/Memo

备注/Memo:
收稿日期：2000-12-25.
更新日期/Last Update: 2001-05-01