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|本期目录/Table of Contents|

应用国产封堵器治疗儿童大型动脉导管未闭的疗效研究

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第4期
页码:
595-597,606
栏目:
临床研究
出版日期:
2010-06-10

文章信息/Info

Title:
Clinical follow-up of transcatheter closure of large patent ductus arteriosus using domestic occluders in children
作者:
杨剑1左健1杨丽芳2张军3李军3孙立军4易定华1
第四军医大学西京医院:1.心脏外科,2.麻醉科,3.超声科,4.放射科,陕西 西安 710032
Author(s):
YANG Jian1 ZUO Jian1 YANG Li-fang2 ZHANG Jun3 LI Jun3 SUN Li-jun4 YI Ding-hua1
1.Department of Cardiovascular Surgery, 2.Department of Anesthesiology, 3.Department of Ultrasound Diagnosis, 4.Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China
关键词:
动脉导管未闭介入治疗超声心动描记术经胸
Keywords:
patent ductus arteriosus transcatheter intervention transthoracic echocardiography
分类号:
R541. 1
DOI:
-
文献标识码:
A
摘要:
目的: 评价应用国产封堵器经导管治疗儿童大型动脉导管未闭的安全性及有效性。方法: 12岁以下大型动脉导管未闭患儿66例,应用国产封堵器经导管进行介入治疗,于术后1、3、6月及每年进行超声心动图等随访,观察有无残余分流及主动脉狭窄等,评估该方法的效果及安全有效性。结果: 技术成功率97%。应用目前最大封堵器失败转外科手术1例,由于重度肺动脉高压,试封堵后肺动脉压力无明显改善而放弃治疗1例。手术即刻残余分流率为23%,随访观察1月后为3%,6月后所有64例患儿均无残余分流。 结论: 国产封堵器经导管治疗儿童大型动脉导管未闭安全可行。
Abstract:
AIM: To evaluate the safety and efficacy of transcatheter closure of large patent ductus arteriosus (PDA) using domestic PDA occluders in children. METHODS: From July 2003 to July 2008, 66 children <12 years old with large PDA underwent attempted transcatheter closure using domestic PDA occluders. Patients were followed-up at 1, 3, 6, and 12 months and thereafter by electrocardiogram (ECG) and transthoracic echocardiography (TTE). Complications including residual shunt and presence of aortic coarctation were observed. RESULTS: The overall technical success rate was 97%. One patient failed with the largest domestic PDA occluder and was treated with open surgery. Treatment was suspended in another patient with severe pulmonary hypertension because of the increased pulmonary pressure after attempted transcatheter occlusion. Instant residual shunt rates were 23% and 3% after 3 months and 0 after 6 months follow-up. CONCLUSION: Complications associated with transcatheter closure of PDA using domestic PDA occluders are relatively low in children. The procedure is safe and efficient and should become the treatment of choice for PDA patients.

参考文献/References

[1]代政学,张玉顺,贾国良,等. Amplatzer封堵器经导管治疗动脉导管未闭169例的随访结果[J]. 心脏杂志, 2002, 14(6):521-523.

[2]Wang JK, Wu MH, Hwang JJ, et al. Transcatheter closure of moderate to large patent ductus arteriosus with the Amplatzer duct occluder[J]. Catheter Cardiovasc Interv, 2007, 69(4):572-578.

[3]Pass RH, Hijazi Z, Hsu DT, et al. Multicenter USA Amplatzer patent ductus arteriosus occlusion device trial: initial and one-year results[J]. J Am Coll Cardiol, 2004, 44(3):513-519.

[4]Masura J, Tittel P, Gavora P, et al. Long-term outcome of transcatheter patent ductus arteriosus closure using Amplatzer duct occluders[J]. Am heart J, 2006, 151(3):755-757.

[5]Ewert P. Challenges encountered during closure of patent ductus arteriosus[J]. Pediatric Cardiol, 2005, 26(3):224-229.

[6]Yan C, Zhao S, Jiang S, et al. Transcatheter closure of patent ductus arteriosus with severe pulmonary arterial hypertension in adults[J]. Heart, 2007, 93(4):514-518.

备注/Memo

备注/Memo:
收稿日期: 2008-09-25. 通讯作者:易定华,主任医师,主要从事先天性心脏病、瓣膜病 及冠心病的外科治疗等研究Email:heart@fmmu.edu.cn 作者简介:杨剑,主治医师,博士Email:yangjianl212@hotmail.com
更新日期/Last Update: 2010-05-20