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Amplatzer封堵器经导管治疗动脉导管未闭169例的随访结果(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2002年第6期
页码:
521-523
栏目:
先心病介入治疗
出版日期:
2002-11-01

文章信息/Info

Title:
Transcatheter closure of patent ductus arteriosus using Amplatzer occluder1~12months follow-up
作者:
代政学; 张玉顺; 贾国良; 李 寰; 刘建平; 张 军; 王小燕
第四军医大学西京医院心血管内科,陕西西安710032
Author(s):
DAI Zheng-xue; ZHANG Yu-shun; JIA Guo-liang; LI Huan; LIU Jian-ping; ZHANG Jun; WANG Xiao-yan
Cardiology Department of Xijing Hospital, Fourth Military Medical University, Xi' an,Shaanxi 710032,China
关键词:
动脉导管未闭;  Amplatzer封堵器; 随访
Keywords:
ductus arteriosus;  patent; Amplatzer occluder device; follow-up
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 应用Amplatzer封堵器经导管治疗动脉导管未闭(PDA)术后随访。方法 全组169例。PDA最窄处直径为4.7±3.8(2.0~13.0)mm。封堵后10 min行降主动脉造影,术后24 h及1,3 ,6月,1年行超声心动图检查随访。结果 166例PDA采用Amplatzer PDA封堵器治疗,3例采用Amplatzer房间隔缺损封堵器治疗。1例PDA术中证实伴有阻力性肺动脉高压未行介入治疗。术后10 min降主动脉造影示,54例存在微~少量残余分流,114例封堵完全无残余分流。术后24 h 13例存在微~少量残余分流,余超声心动图未见残余分流及再通。1例封堵术后10h并发溶血,48 h后行外科PDA缝合术。术后1月超声心动图检查5例存在少量残余分流,术后3月4例存在少量残余分流,6月及1年3例存在少量残余分流,最后行PFM弹簧圈治疗未再见残余分流。无并发症发生。结论 应用Amplatzer封堵器治疗PDA是一种安全有效的介入方法。
Abstract:
AIM 1~12 months follow-up were carried out to asses the safety and efficiency of the Amplatzer occluder in the transcatheter occlusion of patent ductus arteriosus (PDA) .METHODS 169 patients with PDA underwent attempted transcatheter closure of a PDA using the Amplatzer occluder device. The mean PDA diameter at its narrowest segment was 4.7±3.8 mm (rang 2.0 to 13.0 mm). Occlusion was achieved via the antegrade venous approach. The lateral descending aortographies were performed to evaluate the immediate results 10 minutes after the procedure. Follow-up evaluations were performed with 2D echocardiogram,color-flow mapping and Doppler measurement of the descending aorta and left pulmonary artery velocity at 24 h and 1,3,6 and 12 months after implantation.RESULTS: 166 patients with PDA underwent attempted transcatheter closure of a PDA with the Amplatzer PDA occluder device , 3 cases with the Amplatzer atrial septal defect occluder device. One case confirmed with resistant pulmonary hypertension during the procedure was not recommended for transcatheter closure of a PDA. Complete angiographic closure was seen in 114 of 169 patients(67.5%),the remaining 54 patients had a trival to small angiographic shunt through the Amplatzer device. At 24 h,color flow mapping revealed no shunt and recanaliztion in 155 patients(91.7%),a trace to small residual shunt in 13 (7.7%). One case developed haemolysis 10 h after the procedure and surgical closure of the ductus arteriosus was subsequently performed 48 h after the procedure. Color flow mapping revealed small residual shunt in 5 cases at 1 month follow up,4 cases at 3 months follow up. 3 cases were still found to have small shunt and were all successfully closured by PFM coil. No obstruction of the descending aorta or the pulmonary artery branches was noted on 1~12 months Doppler follow-up studies.Neither thromboembolization nor device move or failure was encounted during the 1~12 months follow-up.CONCLUSION: Transcatheter closure using the Amplatzer occluder device is a safe and effective interventional therapy for the majority of patients with patency of the arterial duct.

参考文献/References

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[7]代政学,张玉顺,贾国良,等. Amplatzer封堵器试验性关闭动脉导管未闭合并重度肺动脉高压的临床意义.第四军医大学学报,2001,22(21):1924-1926.

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[10]Bilkis AA,Alwi M,Hasri S,et al. The Amplatzer duct occluder:experience in 209 patients[J].J Am Coll Cardiol,2001,37(1):258-261.

备注/Memo

备注/Memo:
收稿日期：2002-04-25.
更新日期/Last Update: 2002-11-01