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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(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2003年第4期
页码:
347-349
栏目:
介入治疗
出版日期:
2003-07-01

文章信息/Info

Title:
Transcatheter closure of residual patent ductus arteriosus shunting after surgical ligation using the Amplatzer occluder
作者:
代政学1; 王垒2; 李毓杰3; 张玉顺1; 贾国良1; 李寰1; 刘建平1; 王海昌1; 王小燕1
1.第四军医大学西京医院心血管内科,陕西 西安 710032;2.西安市儿童医院;3.西安市第一医院
Author(s):
DAI Zheng-xue1;  WANG Lei2;  LI Yu-jie3;  ZHANG Yu-shun1;  JIA Guo-liang1;  LI Huan1;  LIU Jian-ping1;  WANG Hai-chang1;  WANG Xiao-yan1
1.Cardiology Department of Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China)
关键词:
动脉导管未闭; 术后再通; 介入治疗
Keywords:
ductu sarteriosus;  patent;  residual leaks;  trans catheter closure
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10min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AmplatzerPDA封堵器治疗,1例采用Amplatzer房间隔缺损封堵器治疗。术后10min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24h、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。
Abstract:
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±4mm (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 are sidual PDA with the Amplatzerductal occluder, 1 case with the Amplatzeratrial 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.

参考文献/References

[1] Podner T, Masura J. Transcatheter occlusion of residual patent ductus arteriosus after surgical ligation [J] . Pediatr Cardiol, 1999, 20(2):126-30.

[2] 张玉顺, 贾国良, 刘建平, 等 .三种介入疗法治疗动脉导管未闭的疗效评价 [J] . 心脏杂志, 2000, 12(6):452-454.

[3] 张玉顺, 贾国良, 刘建平, 等. Amplatzer封堵器经导管治疗动脉导管未闭关20例 [J] . 第四军医大学学报, 2000, 21(5):649-650.

[4] 张玉顺, 代政学, 贾国良, 等. 应用Amplatzer封堵器经导管治疗直径≥8mmPDA的疗效评价 [J] . 心脏杂志, 2001, 13(3):204-208.

[5] 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.

[6] Masura J, Walsh KP, Thanopoulous B, et al. Catheter closure of moderate-to large-sized patent ductus arteriosus using the Amplatzer. Duct occluder: immediate and short-term results [J] . J Am Coll Cardiol, 1998, 31(4):878-882.

[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并发重度肺动脉高压的临床意义 [J] . 第四军医大学学报, 2001, 22(21):1924-1926.

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

备注/Memo

备注/Memo:
收稿日期：2002-07-31.
更新日期/Last Update: 2003-07-01